Integrating Clinical & Mental Health

The report, “Integrating Clinical and Mental Health: Challenges and Opportunities” was just released by the Bipartisan Policy Center (BPC) at an event held at the National Press Club on January 24, 2019.

Benjamin Miller, Chief Strategy Officer for the Well Being Trust said, “Much more needs to be done to improve care around mental health to improve coordination of care, avoid duplication of services, and seamlessly move to a comprehensive integration of services.”

The BPC report examines the major barriers to integrating clinical healthcare and mental health services in the U.S. Removing barriers will require addressing disparities in insurance coverage in public and private health, addressing the shortage of mental health professionals, conflicting state laws, and the need to deal with the duplication of services. The report also identifies federal and state policy options that could help remove these barriers and the need to advance evidence-based treatment for mental health care.

Experts in the field, discussed challenges and issues involved in achieving full integration of clinical and mental health. Chris Jennings President, Jennings Policy Strategies and BPC Advisor, moderated a conversation with Patrick Kennedy, Former Representative from Rhode Island and Founder for the Kennedy Forum and Nella Domenici, Senior Advisor, Bridgewater Associates

“Those with mental health and substance use disorders currently face a separate and unequal system of care in the U.S,” reports Patrick J. Kennedy, “Diseases of the brain can and must be treated on par with diseases of the body such as diabetes and cancer while using evidence-based approaches”. As Kennedy emphasized, “There is no health without mental health.”

Nella Domenici told the audience that she had been personally affected by a sibling who was mentally ill and wants to see better mental health outcomes not only in the U.S but also globally. She said, “Mental healthcare should be integrated early as mental health issues can make a strong impact on brain development. It is especially important to take strong measures early especially in the field of pediatrics.”

Kennedy and Domenici both seek to have mental health integrated with primary care at the individual, family, and school level. Domenici also addressed using technology to assist people with mental health issues since there are not enough psychiatrists and psychologists in the country to treat the population affected.

Sheila Burke Strategic Advisor and Chair, Government Relations & Public Policy, Baker, Donelson, Bearman, Caldwell & Berkowitz, and BPC Advisor, conducted a panel presenting new ideas and different viewpoints on achieving the integration for clinical and mental health.

Stephen Cha MD, Chief Medical Officer, United Healthcare Community & State, discussed how mental health has to be separated according to severe versus mild depression. Perhaps access to services for mild cases can be helped with a doctor on the phone giving advice, but other more severe cases may require the integration of medical and behavioral health, and cases related to addiction may require other solutions to stabilize the individual.

Kevin Davidson, Vice President Business Development and Strategic Services at MemorialCare Health System, brought up the subject of “carve-outs” existing in the present system. The BPC report wants to see Medicaid phase out “carve-outs” and require all services in Medicaid managed care contracts to prohibit mental health “carve-outs” by a certain date.

Marian Earls MD, Director, Pediatric Programs and Deputy Chief Medical Officer, Community Care of North Carolina reported how the state of North Carolina is addressing payment barriers so that clinicians can be treated equally and individuals coping with behavior health issues treated appropriately by mental health specialists.

Go to for information on the report.

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