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Although advocacy is a priority for counseling professionals, little is known about counseling advocates' participation in the legislative advocacy process. Recent legislation to address the opioid crisis allowed counseling advocates to provide public comments to advance counselor inclusion in the Medicare program. A thematic analysis of 548 public comments provided on behalf of the counseling profession yielded four categories: advocacy on behalf of (1) the proposed rule change; (2) broader Medicare inclusion; (3) the proposed rule change with an additional request for broader Medicare reimbursement; and (4) no clear advocacy. Subthemes included increasing access to care, qualifications necessary to provide care, and the urgency of the opioid epidemic, among others. Implications for the counseling profession and counselor advocacy are discussed. [ABSTRACT FROM AUTHOR]

Mental health conditions are relatively common among Medicare beneficiaries. Yet, Medicare provider eligibility was last updated in 1989, raising concerns about beneficiaries' access to mental health care in the United States. Beneficiaries are currently restricted from accessing mental health services provided by licensed professional counselors and licensed marriage and family therapists. Little is known about the impact of this Medicare mental health coverage gap (MMHCG) on Medicare beneficiaries. Hermeneutic phenomenology was used to analyze semistructured interviews with 18 beneficiaries who had attempted to access mental health care but were limited due to the MMHCG. Three themes emerged: (a) exasperating experiences with the MMHCG, (b) the MMHCG compounds barriers to mental health care, and (c) Medicare as a flawed system. These findings suggest current Medicare mental health policy interferes with beneficiaries' access to needed mental health services. Implications for the counseling profession are described. [ABSTRACT FROM AUTHOR]