Contributor: Congress Can Bring Mental Health Care to the 21st Century

One of us has lost physician colleagues to suicide and has experienced the frustration of seeking timely behavioral health care for a loved one.

In our clinical work, we have seen what happens when people cannot obtain timely mental health care: depression worsens, anxiety becomes debilitating, substance use disorder goes untreated, and families struggle to find help.

As physicians, we believe patients should not have to wait months or travel hours to receive appropriate treatment.

A Behavioral Health Access Crisis

Our country faces a profound shortage of behavioral health professionals, with some projections reporting that the supply of psychiatrists will shrink by roughly 20% by 2030.¹ More than half of US counties have no practicing psychiatrist, and shortages are even more severe in rural communities. Millions of Americans live in places where finding specialized mental health care requires hours of travel or simply isn't possible at all. A study published in General Hospital Psychiatry illustrates the severity of this access crisis. After researchers attempted to contact 948 psychiatrists across 5 states, they found that only 18.5% were accepting new patients and more than half had no appointments available. For those able to secure a new, in-person appointment, the median wait time was 67 days.² Less than 20% were accepting new patients, and more than half had no availability.

This isn’t just an access problem; it is also an economic one. When psychiatric care isn’t available, patients often end up in the emergency department (ED), contributing to an estimated $8.3 billion in avoidable and preventable mental health ED visits annually.³ A 2024 National Bureau of Economic Research study estimated that untreated or undertreated mental illness costs the US about $282 billion per year through lost work and reduced economic participation alone.⁴

Behind these statistics are personal stories of people confronting a system that too often cannot meet the moment. When someone reaches out for help, the greatest barrier should never be geography, outdated regulations, or a months-long waiting list.

There is an opportunity before us to make the system work better, and Congress should advance the Mental Health TALK SAFE Act of 2026.

Telehealth Can Expand Access

Telehealth does not create more psychiatrists, and it is not appropriate for every patient or every clinical situation. It can, however, make better use of the workforce we have by reducing geographic and transportation barriers, allowing patients to reach specialists outside their immediate communities, and making follow-up care easier to sustain. Since its rapid expansion during the COVID-19 pandemic, telehealth has become an important part of psychiatric practice. For many patients, improved access has meant receiving treatment earlier, remaining engaged in care, and avoiding unnecessary delays. Compared with the 67 days a patient might have to wait for a new, in-person psychiatry appointment, a 2025 study found that telehealth enabled a time to schedule for behavioral health of 0 to 14 days.⁵

Yet the legal framework governing psychiatric telemedicine remains rooted in an era before secure video visits became commonplace. Temporary pandemic-era flexibilities have demonstrated what is possible, but patients and clinicians deserve a permanent, thoughtful path forward.

The Mental Health TALK SAFE Act seeks to provide that certainty. Introduced in the House by Representative Neal Dunn (R, Florida), the act would make 3 specific changes to federal law.⁶

First, it would establish a permanent federal pathway for qualified psychiatrists and psychiatric mental health nurse practitioners to prescribe certain FDA-approved controlled medications following an appropriate telehealth evaluation. Since 2020, clinicians have relied on temporary federal flexibilities that expire on December 31, 2026. When clinically appropriate, telehealth prescribing can be essential for patients who would otherwise struggle to begin or continue treatment. A permanent framework should preserve that access while requiring the same careful assessment, documentation, monitoring, and follow-up expected in any other clinical setting.

Second, the act would also allow patients to see licensed psychiatrists anywhere in the country, an important improvement that significantly helps those in rural or underserved areas. Today, psychiatrists must hold a separate license in each state where a patient is physically located at the time of the visit. Where you live shouldn't determine your ability to get psychiatric care. Talk therapy has largely solved this issue already with interstate compacts that now let licensed psychologists and counselors practice across state lines on their home-state license alone.

Psychiatrists have no equivalent. The Interstate Medical Licensure Compact only speeds up the licensure for each additional state; it doesn’t remove the requirement. Under the act, licensed psychiatrists can treat patients in other states via telehealth without a separate license. This provision would meaningfully expand how many patients a single psychiatrist can actually reach.

Third, this act would pair expanded access with new federal guardrails on telehealth entities prescribing these medications. Individual state licenses already hold psychiatrists accountable for their own conduct, but it does nothing to prevent a business model built around them from overprescribing. Federal prosecutors have identified telehealth entities that paid prescribers based on how many patients received a prescription, rather than the quality of care. These models have also been shown to auto-refill stimulants with no physician review. This act would put in place new standards that would require board-certified clinical leadership and enhance compliance programs and safeguards intended to reduce inappropriate prescribing and discourage these types of business practices associated with overprescribing.

Modernizing Psychiatric Care

We know that untreated mental illness contributes to preventable suffering, disability, and, tragically, suicide. While telehealth will not solve every challenge facing behavioral health, it has become an indispensable part of modern psychiatric care.

For decades, medicine has adapted to new technologies that improve access while preserving quality and patient safety. Telepsychiatry should be no different. The question before Congress is no longer whether virtual mental health care has a role. It clearly does. The question is whether we will build a regulatory framework that reflects today's realities while maintaining the high standards patients deserve.

The Mental Health TALK SAFE Act represents an important step in that direction. I hope lawmakers on both sides of the aisle will continue working together to ultimately deliver what patients need most: timely access to high-quality mental health care.

The stakes are too high, and the need is too urgent to settle for anything less.

References

1. National Center for Health Workforce Analysis. Behavioral health workforce projections, 2017-2030. Health Resources and Services Administration. 2020. Accessed September 22, 2026. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/bh-workforce-projections-fact-sheet.pdf
2. Sun CF, Correll CU, Trestman RL, et al. Low availability, long wait times, and high geographic disparity of psychiatric outpatient care in the US. Gen Hosp Psychiatry. 2023;84:12-17. doi:10.1016/j.genhosppsych.2023.05.012
3. Mulrooney L. Reducing “avoidable” ED visits for mental health could cut billions in costs, improve patient outcomes. AJMC^®. December 13, 2022. Accessed September 22, 2026. https://www.ajmc.com/view/reducing-avoidable-ed-visits-for-mental-health-could-cut-billions-in-costs-improve-patient-outcomes
4. Abramson B, Boerma J, Tsyvinski A. Macroeconomics of mental health: NBER Working Paper 32354. National Bureau of Economic Research. April 2024. Accessed September 22, 2026. https://www.nber.org/system/files/working_papers/w32354/w32354.pdf
5. Capodici A, Noci F, Nuti S, et al. Reducing outpatient wait times through telemedicine: a systematic review and quantitative analysis. BMJ Open. 2025;15(1):e088153. doi:10.1136/bmjopen-2024-088153
6. Rep. Dunn introduces TALK SAFE Act to increase access to mental health care. News release. US Congressman Neal Dunn. January 12, 2026. Accessed September 22, 2026. https://dunn.house.gov/news/documentsingle.aspx?DocumentID=499