Since 1949, May has been observed as Mental Health Awareness Month, which has played an important role in breaking stigma and shining a light on the real-world challenges faced by millions of Americans living with mental health conditions.

But awareness is not enough — especially when access to care remains out of reach for too many.

I am proud to work in community mental health and mental health providers know that timely access to the right treatment, including prescribed medications, can make the difference between recovery and crisis. Yet today, that access is often dictated not by doctors, but by powerful middlemen known as pharmacy benefit managers, or PBMs. These corporations control what drugs are covered, how much patients pay, and whether they can even fill the prescriptions written for them. Their decisions are made behind closed doors, adding stress and confusion to patients already navigating complicated conditions.

To make matters worse, federal proposals like President Trump’s “Most Favored Nation” drug pricing executive order threaten to further restrict access by tying U.S. drug prices to those in other countries. While the goal may be to reduce costs, this type of price-setting could discourage investment in the innovative therapies we so urgently need. Mental health care is not one-size-fits-all, and our system must support the development of new treatments, not stifle them.

If Mental Health Awareness Month is to truly honor the people it represents, then the federal government must act. That means reining in PBM abuses, ensuring that patients can access affordable treatments prescribed by their physicians, and prioritizing the development of better, more effective therapies. People living with mental illness deserve more than awareness — they deserve action.

Elizabeth Cochran lives in Southwest Portland.