The Bipartisan Policy Center (BPC) https://www.bipartisapolicy.org event “Framing a Pathway for Integrating Behavioral and Clinical Healthcare” held August 16, 2018, presented thoughts and ideas on how to proceed on the pathway to integration.
Ben Miller Chief Strategy Officer, Well Being Trust http://wellbeingtrust.org pointed out that while integrating clinical healthcare with behavioral health is very important, social and spiritual needs also need to be considered when integrating care services.
Nella Domenici, Senior Advisor for Bridgewater Associates https://www.bridgewater.com and the daughter of the late Senator Pete Domenici, described how in 1975, there was little discussion on mental health, little effective research being accomplished, difficulties in diagnosing mental health issues, treatments produced a number of side effects, and the cost to deal with mental illnesses in families in that era was very high and many times unaffordable.
As she explained, “Today, the stigma related to mental illness has been reduced, there is more research from public, private, and non-profit resources, but obtaining a diagnosis is still somewhat vague, more treatments are available but not always accessible to everyone, so there is a long way to go.”
Marilyn Serafini, Patient Educator, at Heart Valve Voice U.S. and Health Policy Advisor for BPC https://www.heartvalvevoice-us.org and Moderator for the BPC panel discussion, sparked an informative discussion with the panelists.
John Auerbach, President and CEO, Trust for America’s Health http://healthyamericas.org, started the discussion by saying, “Moving forward with changes related to integration of health services will require authorizations from government to change or streamline regulations. Other factors to consider besides regulations and authorizations, includes contracting and licensing issues.
Tom Betlach, Director, for the Arizona Health Care Cost Containment System https://www.azahccs.gov notes that the goal for AHCCCS is to integrate behavioral health into Medicaid. Today, AHCCCS covers behavioral health services by presenting behavioral health day programs, providing crisis services, promoting prevention and medication training, providing counseling along with case management.
He also reports, “Today, Arizona has five different organizations providing physical and mental health which can create problems when addressing integration of services. Other economic and social issues important to consider relate to housing and employment.”
Patrick Gordon Vice President, Rocky Mountain Health Plans https://www.rmhp.org is responsible for behavioral health services integration initiatives in Western Colorado. He suggests that telehealth can play an important role to break down barriers between clinical and behavioral healthcare.
He also believes strongly in developing public-private partnerships, provide for an integrated leadership, fine tune big data to enable the sharing of data, develop a financing model that will work, develop a workable policy framework, be open to feedback from stakeholders, enable Medicaid and Medicare systems to do a better job of communicating, develop models specifically addressing mental health, and it is important to address payment barriers preventing the use of telehealth.
As National Director for Advocacy and Public Policy for the National Alliance on Mental Illness https://www.nami.org, Angela Kimball explained how school-based mental health services that provide a full continuum of mental health services will really help school systems, children, and their parents.
As reported, school programs addressing mental health are growing at the federal, state, local levels due to advocacy efforts for legislation needed to address children’s mental health reform and mental health parity.
Dr. Jill Haak Bohnenkamp, Assistant Professor, at the Center for School Mental Health, University of Maryland School of Medicine, https://csmh.umaryland.edu has extensive experience in the school mental health research policy area.
She is also Co-Principal Investigator for the National Institute of Justice’s funded randomized controlled trial. This trial is examining how a response is handled and the impact this response can have when an emotional and behavioral health crisis occurs especially in school settings.
She favors the use of telehealth to help with behavioral disorders since young adults are receptive to working with technology and messaging. Challenges to using telehealth can include payment barriers, state issues, how to train or retrain the existing workforce to provide care using technology, and how to deal with privacy and information restrictions in treating behavioral health.