A federal bill, signed into law in October, will increase psychology students' and practitioners' access to the National Health Service Corps (NHSC) Scholarship and Loan Repayment programs. NHSC gives health-care providers financial incentives to work in federally designated areas with health-professional shortages, and the law, known as the Safety Net bill, primarily authorizes the NHSC and Community Health Centers (CHC) programs, two major federal health initiatives for the underserved.
With the encouragement of APA's Education Advocacy Office, NHSC has begun to place greater importance on behavioral and mental health over the last decade, going from funding virtually no mental health-care providers a few years ago to several hundred today. The new language in the Safety Net bill strengthens the role of psychologists in providing behavioral and mental health services to the nation's underserved communities, says Nina Levitt, EdD, APA's director of education policy.
"This is a big win for psychology," explains Levitt, who chaired a coalition of health professions working on the reauthorization of NHSC. "Not only does the law add psychologists to the NHSC scholarship program, but it also includes language that reflects psychologists' role in primary health care and opens the door for us to work in community health centers."
Specifically, the law includes several psychology-friendly provisions:
Psychologists are defined as primary-care providers, along with physicians, nurses and dentists. This clarification means that NHSC will likely include psychologists in the initial round of funding for the loan and scholarship programs.
"It's going to significantly increase the number of psychologists and other mental and behavioral health providers that will be receiving loan repayments and scholarships," says Kristofer Hagglund, PhD, who worked on the legislation as a Robert Wood Johnson health policy fellow with Sen. Tom Harkin (D-Iowa). "Moreover, it's a fantastic precedent for future legislation."
Now that one piece of law refers to psychologists as primary-care providers, he explains, it's likely that lawmakers will include similar language in other legislation.
The term "clinical psychologist" was changed to "health-service psychologist." The change allows psychologists who previously may have been ineligible for public health service programs because of their degree type, such as counseling psychologists, to participate.
"This is a bill about health services, and all psychologists who are trained as health-service providers should be explicitly eligible," says Cynthia Belar, PhD, director of APA's Education Directorate.
Renewal of the federal CHC program for five years, including a provision that allows CHC funds to be used for behavioral and mental health services. While the centers are not required to offer behavioral and mental health services, the law now gives them the option. Relatedly, CHC has pledged to offer behavioral and mental health services at all start-up centers.
The change comes at a key time, says Levitt, since President George W. Bush has promised to significantly increase CHC funding, and that could increase CHC behavioral and mental heath care even more.
The addition of the word "behavior" to mental health care. Throughout the legislation, providers and services are no longer referred to as just "mental health," but instead as "behavior and mental health."
A provision that requires the Health and Human Services secretary to assess the behavioral and mental health needs, as well as physical and oral health needs, of underserved communities.
The Public Policy Office education staff, with support from the Education and Practice directorates, spearheaded the legislative initiative on behalf of psychology and the other behavioral and mental health professions, says Levitt. Psychologists and members of APA's grassroots education advocacy network who contacted their congressional representatives were also key players in passing the legislation, Levitt adds.
For example, in congressional staff meetings, Hagglund explained how mental health is an integral part of overall health. "It was surprisingly easy to educate the congressional staff about the impact of mental and behavioral health--but it could only be done if there was someone at the table," says Hagglund, who encourages other psychologists to get involved in legislation. "Psychologists as constituents are extremely important."
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