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Gray announces new Department of Behavioral Health

Mayor hopes to to streamline city’s response to mental illness and substance abuse

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Vincent Gray, Vince Gray, Mayor of Washington, D.C., gay news, Washington Blade, National Gay Men's HIV/AIDS Awareness Day
Vincent Gray, Vince Gray, Mayor of Washington, D.C., gay news, Washington Blade, National Gay Men's HIV/AIDS Awareness Day

D.C. Mayor Vincent Gray (Washington Blade file photo by Michael Key)

Mayor Vincent Gray on Jan. 11 announced the creation of a new agency designed to better coordinate treatment and services for city residents with mental health and substance use-related disorders.

The Department of Health’s Addiction, Prevention and Recovery Administration and the Department of Mental Health will merge into the new Department of Behavioral Health. Gray stressed during a press conference at the Wilson Building that treating mental illnesses and substance use at the same time leads to a number of positive outcomes that include reduced rates of drug abuse and arrests and less homelessness.

“We know that treatment is effective and people do recover, especially if recovery services are inclusive of the continuum of care,” the mayor said. “We’re putting the best system in place that we believe can make that happen. The overall vision of an integrated system is to effectively serve individuals with co-occurring disorders whether they seek help for mental health or substance use disorders.”

DMH Director Steve Baron and Dr. Saul Levin, interim director of the Department of Health, were among those who spoke at the press conference.

“This creation of the Department of Behavioral Health makes perfect sense at this time,” Levin said. “While SAMHSA (the Substance Abuse and Mental Health Services Administration) and myself as a psychiatrist obviously has believed that you cannot separate mental health and substance abuse from each other, it has taken the country in some ways a little bit longer to get to the idea of saying if we can finally get the co-occurring disorders of mental health and substance abuse being treatment from the moment they enter either the prevention or for treatment and then the recovery, we will get a lot better outcomes coming into it.”

Gray noted more than 35,000 people in the nation’s capital currently receive treatment for either mental health or substance use-related issues. Up to an estimated 50 percent of the aforementioned Washingtonians live with both conditions at the same time.

SAMHSA also estimates mental and substance use disorders will surpass physical diseases as the major cause of disability around the world by 2020.

“We want to challenge assumptions that blame individuals or create misunderstandings and prejudices that make people reluctant to seek treatment,” Gray said. “Instead we are taking a public policy approach based on facts and a scientific understanding of mental illness and substance use disorders. We are focused on prevention, recovery and building healthy communities as a fundamental outcome of all of this.”

LGBT advocates and other health care providers in the city appeared to welcome the mayor’s announcement.

“We know that LGBTQ youth are at greater risk for both mental health challenges and issues as well as to report substance abuse and alcohol abuse issues,” Andrew Barnett, executive director of the Sexual Minority Youth Assistance League, which received a DMH grant to provide an LGBT youth-specific suicide awareness and prevention program, told the Washington Blade. “So if combining these two departments will streamline the process for youth to get connected to services, then that’s good news.”

“This merger is very promising in that, under a new department, federal and local funding for mental health and addictions services will more closely follow patients’ needs,” Whitman-Walker Health Executive Director Don Blanchon added. “It is a good step forward for D.C. residents in need of such important services.”

Gray has yet to announce a director for the Department of Behavioral Health that he said will officially begin operation on Oct. 1.

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Office of National AIDS Policy Director Phillips: Congress must increase funding

‘Without congressional funding we can’t get there’

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The White House in 2011 (Washington Blade photo by Michael Key)

Harold Phillips, director of the White House Office of National AIDS Policy (ONAP), said Monday that Congress must increase funding to end the HIV/AIDS epidemic, including for programs designed around the lives and needs of Americans who are living with the disease.

“We have the support of the Biden-Harris administration, and we have the support at HHS, but without congressional funding we can’t get there,” said Phillips, who delivered his remarks during the AIDS United annual AIDSWatch conference in Washington, D.C.

Phillips echoed remarks by other speakers in calling for Congress to increase appropriations funding for the U.S. Department of Health and Human Services (HHS) Ryan White HIV/AIDS Program, but he also emphasized the importance of “making space for people living with HIV in other aspects of the budget.”

Consistent with the Biden-Harris administration’s focus on employing a whole-of-government approach, Phillips said stakeholders must understand that while “HIV is, yes, a public health threat,” the disease is also “the result of systemic and structural racism,” an intersectional problem requiring more than narrowly focused biomedical or public health responses.

Therefore, he said, these conversations about matters like HIV’s impact on Black lives, or considerations for aging folks who are living with the disease, must be held at places like the White House Gender Policy Council, the National Economic Council, and the U.S. Department of Labor.

“When we talk about ending HIV as a public health threat,” Phillips said, “we also want to end HIV such that it’s not the defining characteristic for people living with HIV and that they can have access to housing, access to employment, good mental health and substance abuse treatment.”

Former ONAP Director Sandra Thurman with ONAP Director Harold Phillips (Screen shot/YouTube)

Under Phillips’s leadership, data on these considerations for those living with HIV/AIDS will be measured for the first time with ONAP’s rollout of new quality of life indicators in the National HIV/AIDS Strategy Federal Implementation Plan.

“There’s an indicator in there that’s self-reported quality of life,” Phillips said, which asks respondents to consider, “how do I feel?” This is important, he added, because people living with HIV may have positive lab results but still feel poorly.

Phillips advised those AIDSWatch participants who are slated to meet with members of Congress and their staffs after hosting a rally on the grounds of the U.S. Capitol Tuesday morning to “build a common bond” with lawmakers by emphasizing the human impact of the appropriations funding for which they are advocating.

An AIDS United spokesperson told the Washington Blade by email Monday that 187 congressional meetings have been scheduled for Tuesday.

Phillips also noted that while “conversations need to happen in Washington, there’s also conversations that need to happen on the state and local level,” where “we’re finding a level of hate and stigma and discrimination that’s on course to try to either stop our progress or take us backwards.”

Speaking before Phillips, Equality Federation Public Health Policy Strategist Mike Webb stressed the importance of policies under consideration by state and local lawmakers. “Our access to PrEP shouldn’t be based on a patchwork of laws by the states,” they said, and HIV-related legislative proposals in many cases would “add criminalizing aspects.”

Laws already on the books that “criminalize the transmission of, or perceived exposure to, HIV and other infectious diseases,” the Movement Advancement Project writes, “create a strong disincentive for being tested for HIV, and result in adverse public health outcomes.”

Phillips and the Biden administration have made modernizing or repealing those laws a top priority.

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Biden budget earmarks funds for HIV along with new programs for PrEP, hepatitis C

Budget seen as preview of Biden’s reelection campaign

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The White House in 2011 (Washington Blade photo by Michael Key)

The $6.8 trillion budget unveiled by President Joe Biden on Thursday includes increased investment in existing programs to fight HIV/AIDS, along with new initiatives to expand access to HIV prevention medications and eliminate hepatitis C.

U.S. House Republicans are expected to kill the proposal, which is nevertheless seen as a possible blueprint for the major themes to come in Biden’s expected reelection campaign.

Major focus areas of the plan include deficit reduction, increased taxes for the wealthy, and increased spending on the military and other endeavors to compete with China.

The HIV + Hepatitis Policy Institute praised the budget in a press release Thursday, writing that it will “significantly increase the federal resources necessary to end both HIV and hepatitis C.”

The group’s president, Carl Schmid, said Biden “recognizes the historic role the federal government must play, and the investments needed to end infectious diseases.”

First, the plan would bolster funding for the Trump-era Ending the HIV Epidemic in the United States initiative by $313 million, bringing the total to $850 million. Second, it would debut a “ten-year $9.7 billion nationwide PrEP delivery program” and a “historic initiative to eliminate hepatitis C.”

PrEP, or preexposure prophylaxis, is a medication regimen that reduces the risk of contracting HIV. According to the HIV + Hepatitis Policy Institute, only 30 percent of patients who could benefit from the drug are taking it.

The new hepatitis C program “seeks to provide outreach, testing, and curative medications to the estimated 2.4 million people living with hepatitis C, many of whom are unaware of their infection.”

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Gov. Newsom: Calif. will not do business with Walgreens after decision to not distribute abortion pill

20 Republican state attorneys general threatened to sue Walgreens for offering mifepristone

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Calif. Gov. Gavin Newsom (D) (Washington Blade file photo by Michael Key)

Gov. Gavin Newsom (D-Calif.) announced on Monday that California will not do business with Walgreens following the company’s announcement of its decision on Friday to not distribute the abortion pill mifepristone in 20 states.

The move comes amid pressure from conservative lawmakers and threats of legal action against Walgreens and CVS from 20 Republican state attorneys general, who claimed in a Feb. 1 press release that selling mifepristone is “unsafe and illegal.”

Mifepristone is still legal in several of the states where Walgreens has decided to stop providing it in response to the specter of lawsuits from state attorneys general: Alaska, Iowa, Kansas and Montana.

Newsom’s office told NPR that California will review “all relationships between Walgreens and the state,” but declined to provide more specifics.

“California won’t be doing business with @walgreens – or any company that cowers to the extremists and puts women’s lives at risk,” Newsom wrote in the tweet. “We’re done.”

“Elected officials targeting pharmacies and their ability to provide women with access to safe, effective, and FDA-approved medication is dangerous and just unacceptable,” White House Press Secretary Karine Jean-Pierre said during a briefing on March 3.

“The administration will continue to stand by the FDA’s expert judgment in approving and regulating medications. And in the face of barriers to access and concerns about safety of patients, healthcare providers, and pharmacists, we will continue to support access to this critical medication within the limits of the law,” Jean-Pierre said.

Meanwhile, Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas is expected to soon rule on a case challenging the safety of mifepristone that advocates for reproductive justice fear could lead to a nationwide injunction prohibiting the sale and distribution of the abortion drug.

Medical experts have slammed the Texas plaintiffs’ lawsuit, arguing that mifepristone’s safety and efficacy have been well demonstrated for years. Kacsmaryk, who was appointed by former President Donald Trump, is nevertheless expected to rule in their favor.

“The plaintiffs who have no legitimate standing have hand-picked him to hear this case that has no merit because they know what they’re getting with Judge Kacsmaryk,” Sen. Ron Wyden (D-Ore.) said last month.

Jean-Pierre addressed the case during a press briefing on March 1: “The decision would be unprecedented, as you know, and devastating to women’s health.  And we may find ourselves in uncharted territory,” she said.

“And so, we’re closely — closely working with the Justice Department and DHS — HHS on this, on how to be prepared for any range of outcome or potential outcomes,” Jean-Pierre added.

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