On Monday, April 20, the U.S. Department of Health and Human Services (HHS) held a roundtable discussion to examine how expanded adoption of health IT can improve outcomes in mental health and substance use care and advance the administration’s commitment to whole-person recovery.

Dr. Thomas Keane, National Coordinator for Health IT, opened the discussion with a few remarks, noting that the participating panel members are all working to ensure that mental health and substance use care achieves parity with traditional medical care so that all Americans can be treated. “Last December, President Trump signed the SUPPORT Act Reauthorization into law and extended billions of dollars of federal funding for programs aimed at preventing overdoses and strengthening treatment and recovery services,” Keane said. “Then, earlier this year, President Trump issued an executive order establishing The Great American Recovery Initiative, which sets the course for a national effort to prioritize addiction treatment and recovery.”

“The Great American Recovery Initiative represents a first-of-its-kind, whole-of-government response to the disease of addiction, which impacts over 48 million Americans,” Keane continued. “As the National Coordinator for Health Information Technology, my office is charged with improving the access and use of electronic health information, including for mental health and substance use care. There are significant technological barriers impacting mental health and substance use care outcomes.”

Keane proceeded to moderate a panel on “Building on Strength: Federal, State & Advocacy Action in Motion.”

Former U.S. Representative Patrick Kennedy II, a leader in mental health, addiction, and brain health policy, stated that over half the clinicians in the U.S., to no fault of their own, do not deliver simple cognitive behavioral therapy. “Let's do specialty coordinated care as a mandate,” he suggested. “Let's do collaborative care codes. We already know that is essential to integrate primary care and mental health.”

“The largest psychiatric hospital systems in this country are county jails and prisons,” Kennedy remarked, explaining that when looking at the cost of mental health and addiction, it’s not just medical costs but also the cost of the criminal justice system that needs to be considered.

Senator Roger Marshall (KS-R) stated that each year, more farmers die by suicide than in farming accidents and noted that there is an epidemic of mental health issues among children. It’s necessary to get to the root of the problem, he said. What’s working in Kansas, he noted, are the certified community behavioral health clinics (CCBHC). Primary care has been embedded in the 28 CCBHCs in Kansas.

“It's my belief that we need one EMR and we need one dashboard that works for all of them,” Marshall said in relation to the number of clinics and the number of EMRs. “Mental illness is one of the nine chronic diseases that drives 85 percent of the spend on health care. So mental health needs its dashboard, just like hypertension needs a dashboard.” Furthermore, he remarked, “Let's not reinvent the wheel. Let's not start another program. Let's accentuate what's working and bring them all together.”

Director of the Agency for Healthcare Research and Quality (AHRQ), Roger D. Klein, M.D., said that the opioid crisis has devastated rural areas in his native state of Ohio. “We're doing research on the best ways to implement medical care and improve outcomes for everybody.” Technology, he said, can help primary care doctors identify mental health needs. “We can take standardized screening tools and embed them into EHRs to encourage routine screening.” With AI analyzing data, he added, you can use predictive analytics to identify patients who are at risk for suicide, an overdose, or a relapse.

Principal Deputy Assistant Secretary for Mental Health and Substance Use (PDAS) at the Substance Abuse and Mental Health Services Administration (SAMHSA), Christopher D. Carrol, detailed that one in six people has a substance use disorder. “A quarter of adults experienced a mental illness last year.” He mentioned the economic fallout, “All of this is costing us billions of dollars a year.” “Through our partnership with ONC,” Carrol remarked, “We're focusing on solutions that get at the root of the problems.”

“We recently announced $69 million in funding that will directly address the root causes of addiction, including homelessness and serious mental illness, and strengthen community safety by expanding treatment that prioritizes recovery and self-sufficiency,” Carrol announced.

Sam Kaardal, Deputy National Coordinator for Health IT and Interoperability, remarked that it's not simply about technology for its own sake; it's about how technology can improve people's access and outcomes.

Carisa Schweitzer Masek, Chief of Staff of the Nebraska Department of Health and Human Services, commented that education is important. She illustrated this by recalling her time as a director of pharmacy at an academic medical institution, when their EMR system needed to be replaced. At that time, she explained, they thought there were rules that hindered them from entering mental health information the same way other information was entered into the EMR.

All these initiatives are going to require better data and better coordination, and it's imperative that all providers and all patients have valuable data, noted Senior Counselor for Policy at HHS Secretary Robert F. Kennedy Jr., Ken Callahan.

“We don't need to look far to see the implications when we can't meet the needs of our patients,” said Pete Croughan, M.D., Deputy Secretary with the Louisiana Department of Health. “It's no secret that Louisiana has its fair share of health challenges.” Rural Health Transformation dollars, he mentioned, will be used for a statewide EMR license.

Tracy Gruber, Executive Director of the Utah Department of Health and Human Services (DHHS), underscored that the relationship between behavioral health, physical health, and outcomes is interlinked. In Utah, she has seen the value of bringing together the private and public sectors. “We're planning to make it accessible to rural health clinics, parish health units, and hopefully even prisons….I think that just changes the whole game.”

Tia Marcel Moretti, the Ohio Department of Behavioral Health’s Chief Advisor and Deputy Director of the Office of Community and Family Resiliency in 2024, expressed a deep passion for increasing behavioral health's business acumen. “Often,” she said, “I see that we are paying for activities and not outcomes, where if we could elevate our data to a platform that was interoperable, we could operate in a grant environment.” “Much like claims adjudication,” she explained, “so that we can see the whole picture and not have the blind spots of transition of care and be able to calculate the total cost of care in grant-making environments.” “Bringing in Epic in hospitals has allowed us to practice what we preach in terms of centralizing, watching patient movement opportunities,” Moretti added.

“We're here to focus on behavioral health, mental illness, and substance use, where failure has immediate and sometimes fatal consequences,” U.S. Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. said. Nearly 50 million Americans struggle with addiction across the country, and families are dealing with depression, anxiety, and substance use disorders that often disrupt their lives.”

“Providers lack critical information,” RFK Jr. added. “Patients fall through gaps that should not exist, and we're not going to accept that anymore….That starts with making health data work the way it should.”

“Today, too many clinicians are forced to make decisions without a complete picture,” RFK Jr. continued, “Providers should have seamless access to all the information.” SAHMSA and the ONC have launched pilot programs nationwide to test new data-sharing standards and strengthen integration between behavioral and physical healthcare.

Additionally, RFK Jr. said, “We're also advancing the careful use of artificial intelligence (AI). AI can reduce administrative burden, eliminate redundancy, and support clinical decision making.”