Federal Advocacy for Access to Treatment-Resistant Depression Care
April 14, 2024
Advancing Care for Treatment-Resistant Depression in Montana
NAMI Montana has been a strong advocate for improved care for treatment-resistant depression (TRD) for many years—especially following the loss of our dear friend and ally, Mike Franklin.
Treatment-resistant depression affects approximately 30% of people living with depression. It refers to depression that does not improve after standard treatments such as traditional psychotherapy and first-line antidepressant medications. More detailed diagnostic and treatment pathways can be found in the Department of Defense / Veterans Affairs Depression Treatment Guidelines:
https://www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916.pdf
People living with TRD face a significantly elevated risk of suicide, making access to effective next-step treatments critically important.
Evidence-Based Next Steps for TRD
When depression does not respond to standard treatments, clinical guidelines often recommend advanced interventions such as:
Transcranial Magnetic Stimulation (TMS)
Electroconvulsive Therapy (ECT)
Both treatments are supported by strong evidence and are lifesaving for many people with severe depression.
Advocacy Wins for Access to Care
NAMI Montana has successfully advocated for several major policy changes to expand access to advanced depression care, including:
Montana Medicaid reimbursement for TMS, increasing access for low-income Montanans
Expansion of care for veterans with treatment-resistant depression through Section 401 of the Guaranteeing Healthcare Access to Personnel Who Served (GHAPS) Act, developed in partnership with Senator Jerry Moran of Kansas
https://www.congress.gov/bill/117th-congress/senate-bill/1863/text
Laying the Groundwork for the Next Generation of TMS
This spring, NAMI Montana has been working to lay the foundation for Montanans with treatment-resistant depression to access the latest FDA-approved form of TMS, known as:
Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT)
SAINT is a rapid-acting, high-dose TMS protocol that has shown remarkable results in people with severe, treatment-resistant depression. NAMI Montana has followed its development for years through updates from the Brain & Behavior Research Foundation.
We are excited that SAINT is now being offered commercially through Magnus Medical, making broader access possible nationwide.
SAINT overview: https://bbrfoundation.org/content/fda-clears-saint-rapid-acting-brain-stimulation-approach-those-suffering-resistant-major
Magnus Medical: https://www.magnusmed.com/
Federal Advocacy Efforts
Our primary federal advocacy work to support SAINT access in Montana has been in partnership with Senator Steve Daines, due to his critical role on the U.S. Senate Finance Committee.
We are especially grateful to Grace Bruno, a member of Senator Daines’s staff, who has been instrumental in opening doors with additional Senate offices and helping advance this issue.
This is a long-term effort involving significant regulatory and reimbursement challenges, but we are encouraged by the momentum and deeply appreciative of the Senator’s team for pushing this work forward.
Thank You
This progress would not be possible without the support of our generous donors, partners, and advocates.
We look forward to sharing future updates on this work at:
https://www.namimt.org