Biden’s American Families Plan is also a Plan for Mental Health

Pressing pause on a National Mental Health Rescue Plan to appreciate the American Families Plan’s positive contributions.

I have to admit, when I first read President Joe Biden’s American Families Plan, I was disappointed to see the phrase “mental health” only pop up once. With the exception of what was allotted to community-level programs that provide mental health screening, treatment, and emergency services in President Biden’s American Rescue Plan – see here for a mental health summary – it was starting to seem like mental health was never going to be given the critical support it’s due.

With that initial reaction, I was planning to pick up with where we left off last week, doubling down on the need for a National Mental Health Rescue Plan and talking about what should be its second ingredient: Efforts to build a better, more equipped mental health workforce.

This is still important, and I will write that post. But you’re going to have to wait one more week, because there is something that really needs to be said about President Biden’s American Families Plan, which is how, even with only one explicit mention, it would have a massively positive impact on mental health in America.

The plan “ ... is an investment in our children and our families—helping families cover the basic expenses that so many struggle with now, lowering health insurance premiums, and continuing the American Rescue Plan’s historic reductions in child poverty.”

It specifically calls for:

● Universal preschool for all three- and four- year-olds;

● A cap on how much low- and middle-income families spend on child care (no more than 7% of their income);

● Paid family and medical leave;

● An expansion of the American Rescue Plan’s health insurance tax credits;

● Two free years of community college;

● Nutrition assistance, and more.

The ability to afford childcare, health care, continuing education and take time off work so that you can heal are all things that cause stress and take a toll on our collective well-being – and are especially impactful in the current moment. More than one in four mothers surveyed by Kaiser Family Foundation said that the pandemic took a negative toll on their mental health. And even more than mothers, 82% of fathers surveyed by the American Psychological Association said they could have used more emotional support than what they’ve received since the pandemic started. In that same survey, 24% of parents said they were diagnosed with a mental health disorder since the pandemic started.

Kids are having a hard time, too – and I’m sure that stressed-out parents haven’t been helping the situation. Thoughts of suicide or self-harm have doubled since 2016 among kids as young as 6-12. And the opening quote on this Wall Street Journal piece really wrenches your heart: “Every day is the exact same. You kind of feel like, what’s the point?”

By taking financial burden off parents – through childcare, education, and by making it easier for low and middle income parents to provide their kids with healthy foods – American parents will have less stress in the short term that could have a big impact on the long term.

For example, in a survey of college students located all around world – including countries with free or nearly free college experiences like Germany, France, Norway and Spain – 46% of U.S. undergraduate respondents said they lose sleep worrying about their debt, an indicator of poor mental health that is 11% higher than the worldwide average. One in five said it caused so much anxiety they sought medical help.

In addition, where paid family leave and postpartum depression are concerned, areas that offer paid family leave tend to have lower rates of postpartum depression among women. The United States currently only requires employers to provide 12 weeks of unpaid maternity leave, but Canada, by comparison, provides 15 weeks of paid leave. According to one study, the postpartum depression rate among Canadian women after 12 weeks was just 8%. (Twelve weeks was also the point at which this study found that noticeable week-to-week differences in mental health improvements stopped being observed.) It varies by state in the U.S., but rates of postpartum depression are almost always in the double-digit range, reaching as high as 23.5% in Mississippi.

And herein lies my epiphany: Sometimes in our fight for more aggressive mental health reform we forget that what actually contributes to our mental health – our positive mental health and well-being – are factors that have little to do with health care. I know this, I write about it, talk about it, and sing it from the rooftops, but when I actually don’t see the words “mental health” mentioned, I react in the way I imagine many others did. 

This is our problem and our solution. Mental health is more than the pieces of policy that fund programs – it’s more than simply highlighting an often faulty delivery setting and saying “do more of that.” Mental health is made up of factors that are far beyond anything that ever comes close to a clinic, and we should not only more readily embrace this, but look to solutions that enable this.

For us to begin to see mental health for what it is – foundational to our health – we have to transcend traditional ways of thinking about solutions. We have to begin to better approach policy like we approach everyday social, economic, and community issues.

We still need to treat mental health as the problem that it really is – straightforwardly and aggressively, as a National Mental Health Rescue plan would do. But for right now, let’s rejoice. Mental health may not have gotten more than one direct mention in President Biden’s American Families Plan, but it will be a direct beneficiary.