Amid the Covid-19 pandemic, the United States is experiencing a mental health epidemic that has seen rates of substance use disorder (SUD) skyrocket. Provisional data for February 2022 from National Center for Health Statistics of the Centers for Disease Control and Prevention It found that during the 12-month period ending September 2021, an estimated 104,288 people in the United States died from drug overdoses.
To make matters worse, behavioral health providers are increasingly under-resourced and struggling to keep up with the surge in patient demand. At the same time, we are seeing increased awareness of behavioral health conditions that can help reduce stigma. This has led to more people seeking care; however, it is often difficult to find affordable, evidence-based care.
Recognizing the need for a stronger system to facilitate access to behavioral health care, the federal and state governments are stepping in. The 2021 American Rescue Program Act, which became law in March 2021, includes billions of dollars in life support-saving mental health and substance use services. The legislation seeks to improve behavioral health care by allocating $4 billion to programs that support mental health and SUD prevention and treatment.This includes Substance Abuse and Mental Health Services Administration (SAMHSA) Block Grant, Certified Community Behavioral Health Clinic (CCBHCs) Expansion Grants, Provider Relief Fund Provides additional funding for those serving rural communities and for SAMHSA and Health Resources and Services Administration (HRSA) programs.
While this legislation represents an important step forward, it also underscores the growing need for comprehensive behavioral health capacity management and referral technology solutions that integrate across states. The benefits of such a system help health systems, payers, and state and county governments create a trusted treatment network to improve support and care for patients in need, improve public health, and enable a holistic approach to behavioral health treatment perspective.
Barriers to holistic care for behavioral health
A key problem with better understanding of patient health is that health data is siloed across disparate systems across the country. This means that healthcare providers, regardless of their specialty, do not always have access to the necessary health data needed to incorporate physical fitness into their overall behavioral health and wellness programs.
Traditionally underserved and neglected patient populations face additional challenges. We should be able to track these high-risk groups from a behavioral health perspective. For example, we should be able to alert their provider, clinician or care manager no matter where they are when they are admitted to the hospital for an overdose. If they don’t have a provider, they should be linked for final evaluation and treatment. This way, they can get the care they need when they are discharged from the most vulnerable emergency departments (EDs).
This can be accomplished by identifying and tracking mental health and SUD inpatient and outpatient treatment and social services resources within a single network. The technology can track usage and referral patterns at the organizational, regional, and state levels to help identify service gaps, inform policy and program design, and use resources in a more cost-effective manner. Most importantly, it should be integrated so that behavioral health providers can refer to primary care, primary care providers can refer to behavioral health providers or EDs, and primary care offices with behavioral health coordinators can use the system to follow to continue to care.
Holistic View Solutions
Now, as care transitions between clinicians and payers, there is a desire for real-time patient data. While many health facilities and providers currently do not have access to this life-saving critical care coordination information, healthcare IT solutions can be used to facilitate rapid provider referrals and feedback.
A recently implemented example of holistic care is the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access Rule Electronic Notification Condition of Participation (CoP), which requires hospitals across the country to send real-time ADT notifications to everyone from May 2021 Post-Acute Providers, PCPs, and Primary Care Entities are required starting May 1. The regulation aims to help hospitals better serve patients by improving care coordination and enhancing interoperability among providers. Healthcare providers integrating CMS-compliant solutions will now receive electronic notifications when patients experience care events. They will receive electronic notifications about their patients’ hospitalizations and will be notified if their patients are hospitalized for behavioral health conditions.
Going Further: Building Infrastructure to Support the Future of Crisis Care at the Community Level
The federal government is also trying to standardize access to emergency behavioral health care across the United States, which is absolutely necessary. Their goal is to equate behavioral health care with physical health care. This is done by handling behavioral health emergencies in a similar way to physical emergencies. While the concept of crisis care and telephone hotlines is not new, previous approaches to behavioral health crisis management have been piecemeal in many communities. To keep too many people from getting stuck, states and communities need a comprehensive, integrated behavioral health crisis infrastructure to close the gaps in care.
To achieve this, communities should enable clinicians to speak to patients in need, and they must be able to dispatch a mobile crisis team, the equivalent of an ambulance. Clinicians can then evaluate patients in the field and take them to the emergency room or 24-hour emergency services for observation and, if needed, transfer them to more intensive care or outpatient care. This level of crisis support enables patients to urgently access the care they need, while also giving providers a broader understanding of their existing conditions and health needs.
The federal government has recognized the need for a system to boost treatment capacity, provide situational awareness about treatment availability, and enable digital referrals for whole-person care. However, they needed a technology to connect the call lines as well as the clinician’s electronic health record system — all of which are required to support the National Suicide Hotline Designation Act.The Act stipulates that “988” is National Suicide Prevention Lifeline Beginning July 16, 2022, the Federal Communications Commission is required to designate “988” as the general telephone number for the National Suicide Prevention and Mental Health Crisis Line.
With a crisis management technology infrastructure, crisis call center staff can digitally communicate with mobile crisis departments and treatment providers, view treatment availability in real-time, and dispatch patients to mental health and SUD-related crisis situations. In this way, they can support collaboration among behavioral health and developmental services, law enforcement agencies, hospitals and medical facilities, and a variety of other stakeholders.
Link to Health Data for Whole Person Care
Finally, in order to collectively improve access to behavioral health services, we must look at it through a data lens. Providers, treating organizations, referral organizations, health systems, managed care organizations, social services, and state entities have laid the groundwork for improving access to care through secure access to patients’ health data. This data informs all parties caring for patients about their status and enables them to get the urgent care they need while preventing them from falling through the cracks.
Going forward, we must continue to work toward our collective goal of integrating a holistic view of care to deliver actionable behavioral health services. By leveraging health data interoperability solutions and the real-time availability of data embedded in point-of-care clinical workflows, we can enable providers to identify and monitor mental health and SUD inpatient and outpatient treatment and social services resources in an integrated A network for decision support and patient analysis support.
Facilitating this collaboration in behavioral healthcare coordination networks through real-time patient data, analytics, and clinical decision support tools can deliver holistic care across the healthcare ecosystem. Supporting this real-time care coordination will benefit the physical and behavioral health of every patient, leading to better outcomes and dramatic progress in addressing the mental health and substance use crisis that has shortened the lives of too many people and grieved family and friends .
Image Credit: Aleksei Morozov, Getty Images
