---
id: "coronavirus-smarter-crowdsourcing:recommendations/government-capacity-and-regulatory-environment"
type: "GovLab policy recommendation"
title: "Government capacity and regulatory environment"
url: "https://coronavirus.smartercrowdsourcing.org/recommendations/government-capacity-and-regulatory-environment"
summary: "Improve legislative and regulatory frameworks for mental health services."
source: "The GovLab (coronavirus.smartercrowdsourcing.org)"
licence: "Creative Commons Attribution-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-sa/4.0/)"
---

# Government capacity and regulatory environment

Improve legislative and regulatory frameworks for mental health services.

- Part of: [Smarter Crowdsourcing in the Age of Coronavirus](https://coronavirus.smartercrowdsourcing.org/), [all recommendations](https://coronavirus.smartercrowdsourcing.org/recommendations)

## Strategy 1

Create a legal framework to regulate and fund mental health priorities

- Timeframe: 1+ years (structural change)
- Audience: Vulnerable Populations
- Type: Partnerships, Vulnerable Populations
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/create-a-legal-framework-to-regulate-and-fund-ment

### Actions governments should take (strategy 1)

1. Review existing provisions regulating and legislating mental health services in the jurisdiction
2. Advocate for economic stimuli to include appropriations for mental health services and providers.
3. Reduce regulatory requirements for face to face service provision, thus allowing service provision to capitalize on remote technologies like telemedicine or hotlines.
4. Reduce regulatory requirements for licensure or credentialing across jurisdictions thus allowing providers to practice via technologies in jurisdictions where they are not licensed.
5. Review legal regulations for controlled substances like methadone, antidepressants, or other key medications used to treat depression, substance abuse, and other mental health issues.
6. Consider means of reducing barriers for patients to access these essential medications while minimizing risks for in-person visits and risks of transmission of the virus.
7. Include provisions for paid sick leave for people who have COVID-19 symptoms, need to quarantine, or are caring for children or ill family to reduce stress and financial burdens of the illness.
8. Include provisions that mandate the coverage of mental health and behavioral health services at the same level as other physical health services or treatments.
9. Include provisions that provide financing for mental health services, including specific details on how services that support marginalized or poor populations will be funded and prioritized.

### Examples from around the world (strategy 1)

1. Ireland established the Mental Health Act in 2001 sets out legal procedures for the admissions and treatment of mental health patients, it also established a [Mental health commission](https://www.mhcirl.ie/About_Us/) which is incharge of ensuring and promoting good practices in the delivery of mental health services. Currently, the Commission was tasked with developing a [risk assessment framework](https://www.mhcirl.ie/for_H_Prof/MHC%20Covid-19%20Risk%20Assessment%20Framework/) as part of enhanced public health measures to ensure the proper disease management of COVID-19 and to work with national and regional governance to assess and support their mental health services. Given that a legal framework already existed it allowed for the [Emergency Measures in the Public Interest Covid-19](http://www.irishstatutebook.ie/eli/2020/act/2/enacted/en/html) Act to be passed in 2020.

## Strategy 2

Create a national mental health plan to guide the implementation of the resulting legislation and regulations

- Timeframe: 3-6 Months (medium)
- Audience: Government Workers
- Type: Research, Policy/Legislative/Regulatory, Capacity Building
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/create-a-national-mental-health-plan-to-guide-the-

### Actions governments should take (strategy 2)

1. Identify national or subnational priorities, goals, and/or objectives pertaining to prevention, screening, assessment, and treatment of mental disorders and behavioral conditions.
2. Articulate them clearly in the plan, with specific timelines and indicators to measure these outcomes and objectives.
3. Consider the needs of populations that may be experiencing disparities in access, treatment and mental health outcomes. For example, racial/ethnic minority populations, poor populations, and rural communities may be less likely to have access to care and more likely to receive lower-quality care.
4. Ensure that implementation plans integrate monitoring, evaluation and learning opportunities into all aspects of new work.
5. Take advantage of natural experiments that have resulted from responses to the COVID-19 crisis, such as quasi-experimental studies of mental health outcomes based on changes in use of telehealth, hotlines, apps, or other innovations that have become prevalent during the pandemic.
6. Ensure the plan outlines such areas as reimbursement rules, patient eligibility criteria for programs, rules regarding what types of services are permitted in certain settings, accreditation requirements, and what types of waivers may be appropriate in certain situations.

### Examples from around the world (strategy 2)

1. [Chile established the National Mental Health Plan 2017-2025 that sets out guidelines for the implementation of a community model of mental health care and that also considers the establishment of a legal framework in order to establish a Mental Health law in the upcoming years,](https://www.minsal.cl/wp-content/uploads/2017/12/PDF-PLAN-NACIONAL-SALUD-MENTAL-2017-A-2025.-7-dic-2017.pdf)

## Strategy 3

Promote public policies and interventions that prioritize mental health services for healthcare workers and frontline personnel

- Timeframe: 1-3 Months (immediate)
- Audience: Healthcare Providers, Essential Workers, Organized Civil Society, Nonprofits
- Type: Policy/Legislative/Regulatory, Communications
- Strategy page: https://coronavirus.smartercrowdsourcing.org/strategies/promote-public-policies-and-interventions-that-pri

### Actions governments should take (strategy 3)

1. Develop, fund, and implement specific hotlines and telehealth services that provide expedited services for healthcare workers and frontline personnel.
2. Conduct studies and research that specifically consider the impacts of COVID-19 on the mental health and emotional wellbeing of healthcare workers and essential workers.
3. Establish government programs to support the mental health needs of healthcare workers and essential workers, prioritizing them as a vulnerable or high risk group.
4. Encourage hospitals and healthcare organizations to conduct regular screenings for mental health problems in frontline and healthcare workers.
5. Train workers peer to identify burnout and offer informal support and counseling to their peers.
6. Encourage hospitals and healthcare organizations to provide mental health resource materials for their staff and offer training in stress management.

### Examples from around the world (strategy 3)

1. To address the large numbers of healthcare workers suffering mental health disorders, [Penn Medicine](https://www.pennmedicine.org/) (Penn), in collaboration with UnitedHealth Group, created [COBALT](https://www.penncobalt.com/)— “a digital platform that offers immediate access to mental health support for health care workers during this critical time.” The system connects employees in need to mental health and wellness content, live groups, and individual virtual support all online. The platform employs targeted assessments to direct specific content to individuals presenting specific conditions and to triage users to specific types and modalities of support. The platform makes available resources including “resilience coaches, psychotherapists, and psychiatrists, as well as podcasts, articles, mindfulness sessions, and other group support.”