Steps Towards Health Equity in Opioid Response Legislation
By Isha Weerasinghe
After six hearings on the Hill, deliberations, and discussions with advocacy organizations, the Senate passed the Opioid Crisis Response Act of 2018 this week. The bill builds on previous legislation including the Comprehensive Addiction Recovery Act, creates new programs, and bolsters current practices to begin addressing prevention and trauma from the opioid crisis. We hope this bill’s passage is the first step in thinking comprehensively about how economic stability, environment, family dynamics, history, gender, sexual orientation, disability, and race all contribute to trauma.1
The bill focuses on trauma experienced by infants, young people, women, and families by:
- Supporting Centers for Disease Control and Prevention efforts to collect and report data through the Behavioral Risk Factor Surveillance System (BRFSS), the Youth Risk Behavior Surveillance System (YRBSS), and other public health surveys;
- Creating an interagency taskforce to identify, prevent, and mitigate the effects of trauma on infants, children, youth, and families;
- Linking education and mental health systems to help youth access the mental health services they need;
- Increasing funding for the National Child Traumatic Stress Initiative to bolster technical assistance, as well as evaluate and share best practices in trauma-informed care;
- Providing incentives for behavioral health providers to use electronic health records to improve quality and coordination;
- Updating behavioral and mental health professional education to include trauma-informed care; and
- Creating a Technical Assistance Center at the Substance Abuse and Mental Health Services Administration (SAMHSA) to help organizations provide peer support services to people affected by substance use.
To ensure the bill was inclusive of all communities, CLASP helped inform the drafting of it by expanding definitions of where data would be collected, suggesting names of interagency taskforce members, and expanded the definition to include schools in all Health Professional Shortage Areas among the locations where National Health Service Corps providers could provide mental health services.
Understanding how trauma affects diverse communities and individuals, as well as how these people and communities approach care, must be a key part of implementation and technical assistance efforts. Now that the bill has passed, administrators developing and refining programs related to the bill language must consider the following:
- Data collection processes take communities of color, including immigrants, into consideration, through providing information in-language, and in the places where communities of color live, work, and play.
- Those affected by trauma and substance use are included as voices of a community advisory arm to provide guidance and inform the interagency taskforce proposed in the bill.
- Mental health services in schools include what works for youth—including peer support.
- Grants support a diverse array of community-based organizations that serve different communities, including communities of color.
- The definition of what is considered “trauma” is sufficiently broad, as researchers try to understand what trauma is and ways to address it.
These building blocks to better understand the impact of trauma on mental and behavioral health is the first step in a long process toward better providing needed supports for the communities most in need. CLASP supports the trauma-informed language in the Opioid Crisis Response Act of 2018 and hopes future bills will include language focused on trauma in all communities. The opioid crisis has grave implications across race, gender, and geography. That’s why it is critical that any legislation takes this into consideration and ensures the equitable distribution of resources to help children, youth, and families in all communities heal.
1 When using the term “trauma,” CLASP looks at a number of factors, including exposure to community and interpersonal violence, financial strain, family dynamics, and exposure to racism and discrimination. To learn more, read Everybody Got Their Go Throughs: Young Adults on the Frontline of Mental Health.