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

I have lost physician colleagues to suicide.

I have cared for patients who waited months to see a psychiatrist, with their depression, anxiety, or substance use disorder worsening while they waited for help. And like millions of American families, my own has experienced the frustration of trying to access timely behavioral health care for someone we love.

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. At the same time, one study from General Hospital Psychiatry has shown that after trying to reach nearly 1000 psychiatrists across 5 states, there was a median wait time of 67 days for a new, in-person appointment.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 the statistics of America's mental health crisis are the personal stories like mine about 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 When someone reaches out for help, the greatest barrier should never be geography, outdated regulations, or a months-long waiting list.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 has transformed access to care since it was accelerated by the COVID-19 pandemic, across specialties. 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 permanently clarify telehealth prescribing rules for approved mental health medications, allowing qualified psychiatrists and psychiatric mental health nurse practitioners to prescribe certain FDA-approved controlled medications following an appropriate telehealth evaluation. Since the pandemic, psychiatrists have only been able to prescribe controlled medications via telehealth because the Drug Enforcement Administration and HHS continue to issue temporary extensions of an emergency rule adopted in 2020. Yet, the current extension expires December 31, 2026. This act would codify this rule, making it possible to prescribe controlled medications via telehealth, a critical point of access and adherence, particularly for patients struggling with substance use disorders.

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. 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 drastically expand how many patients a single psychiatrist can actually reach.

Lastly, 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. Although 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