Across the nation, healthcare systems increasingly identify behavioral health as a pressing health care need in their communities. The Health Research & Educational Trust review showed that behavioral health was the second most prioritized community health need.
In nearly every setting, from emergency departments and acute inpatient units to specialized care, almost 25% of patients admitted also have a behavioral health diagnosis. Yet, despite these statistics, comprehensive models to improve behavioral health patient care are challenging to find and implement.
Behavioral health disorders encompass both mental illness and substance use disorders. Mental illnesses are specific, diagnosable disorders, while substance abuse disorders result from inappropriate use of alcohol, prescription, or illegal drugs. (Source: HHS, Mental Health: Report of Surgeon General, 1999 American Society of Addiction Medicine, 2011)
Though mental health and substance use disorders are common worldwide, the quality of care for these disorders has not increased at the same rate as for physical conditions.
In December 2019 and January 2020, the American Hospital Association (AHA) interviewed senior health care and community leaders from hospitals and health systems across the United States. Though each organization’s community profile was unique, all faced a common challenge: meeting their community’s behavioral health care needs.
The interviews identified critical characteristics of emerging behavioral health networks across the country that can offer insight to other communities. Their wisdom provides hope for developing creative, collaborative solutions that include these five strategies to improve behavioral health patient care:
- Integration of behavioral health and primary care
- Community partnerships
- Coordination of care through technology
- Removing the barrier of stigma
- Leveraging telehealth solutions for improved behavioral health patient care
Integration of Behavioral Health and Primary Care is Essential to Effective Patient Care
Historically, behavioral health and physical health care have operated as separate systems in this country. However, suppose we embrace the definition of health by the World Health Organization in its constitution as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” In that case, addressing the population’s behavioral health needs is crucial.
Consider this: one in four Americans will experience a mental health or substance use disorder this year, and most of them will have a comorbid physical health condition. Unfortunately, many will receive care without having their underlying behavioral health needs addressed, resulting in poorer medical outcomes compared to the general population of patients.
Integrating behavioral health across the care continuum can help create a more comprehensive and integrated approach to health care. As a result, patients can receive the services they need, when they need them, whatever setting they are in. In addition, these efforts can provide better coordination between primary care providers, mental health and behavioral health specialists, and case managers. Proven outcomes include:
- Improved mental health
- Increased adherence to treatment
- Improved quality of life
- Increased patient engagement and satisfaction
Community Partnerships are Vital to Improved Behavioral Health Patient Care
Building successful community partnerships is a vital element of improved behavioral health services access. The effective collaboration of general health care, behavioral health, and other human service providers can decrease fragmented care, reduce costs, and improve the patient experience.
A structured community network can include community-based mental health clinics, primary care providers, public health departments, schools, law enforcement, housing authorities, and faith-based organizations. These cross-sector partnerships are essential to maintaining the health of individuals living with complex medical and social needs. Ironically, as discussions are held within communities, network members realize that each depends on each other’s services, yet they had not been working collaboratively.
Once they came together with common goals, the need for collaboration became crystal clear.
Across the country, healthcare and community-based organizations (CBOs) are partnering to address strategies to improve behavioral health patient care. For example, the Center for Health Care Strategies and the Nonprofit Finance Fund has established a set of resources to help communities address common barriers to care and strengthen collaboration.
These resources establish a framework for describing integration between healthcare and CBOs, help partners articulate the value of collaboration, and guide them to align goals, communicate with stakeholders, and advocate for funding.
Coordination of Care Through Technology is Key to Improved Behavioral Health Patient Care
Technology must be a vital part of the solution to improving behavioral health care. These innovative platforms enable care coordination at its source. In addition, the ability to share information is vital to meeting healthcare/community-based organization partnership goals.
Cloud-based software platforms like Julota allows agencies to share and track information about the people served and the services used. It can reduce burdens on staff through automating complex workflows, referrals, data aggregation, and reporting.
Historically, multiple phone calls and or faxes were needed to coordinate patient care and transition, often leading to misallocation of resources. Leveraging care coordination through Julota’s patented TouchPhrase Interface means that collaboration can be established with a few clicks. As a result, response time is reduced, along with wasted efforts in communicating with first responders and other providers.
Access to an individual’s information allows the health care team to obtain the whole picture of the patient’s health and better understand possible barriers to medication or treatment adherence directly at the point of service. In addition, information sharing through Julota’s platform remains secure and out of view of unauthorized parties.
From the perspective of behavioral health professionals, interoperability between the disparate computer systems in the community is paramount to success. Julota’s cloud-based computing makes it easy for everyone involved to log onto the system using smartphones, laptops, tablets, or desktop computers. Care can then be easily coordinated among the various community services such as mental health clinics, EMS, law enforcement, social services, and other participating agencies.
Removing the Barrier of Stigma Provides Hope for Behavioral Health Patients
Words hurt. Stigma is an ugly word and even uglier to experience. Yet approximately 75% of people with mental health or substance use disorders say they have endured the pain of stigma.
Despite ongoing efforts from healthcare providers, mental health organizations, and those with lived experience, stigma continues to be one of the most persistent drivers of adverse outcomes within the behavioral health community. In addition, it is often cited as a specific barrier to receiving care.
Helping communities to better understand mental illness and substance use disorders through awareness can help remove the barrier of stigma and provide hope for behavioral health patients.
Open communication is key to eliminating the stigma and discrimination faced by those with behavioral health disorders. The National Alliance on Mental Illness (NAMI) has identified ways to combat stigma, such as:
- Talking openly about mental health
- Being conscious of language
- Showing compassion for those with mental illness
- Being honest about treatment
- Letting media know when they are stigmatizing
Positive community relations provide opportunities to break down misperceptions, promote recovery, and open the door for innovative community-based solutions to behavioral health care needs. In addition, sharing stories on social media has played a significant role in reducing stigma and providing hope and encouragement.
Stories build connections, and connections create a sense of community. For example, NAMI has a Facebook page that provides information about events and a safe place to discuss concerns. With compassion, communication, and understanding, communities can begin to knock down the barrier of stigma.
Leveraging Telehealth Solutions for Improved Behavioral Health Patient Care
The Health Resources and Services Administration defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical healthcare…”. Telehealth includes the use of electronic health records (EHRs), streaming media, and video conferencing. It can be used across a continuum of care to deliver and enhance behavioral health services.
Leveraging telehealth solutions for improved behavioral health patient care is becoming a promising strategy to improve access to mental health and substance use disorder treatment across the United States. Psychiatrists are the most common behavioral health professional to use telehealth, followed by mental health counselors.
During the recent pandemic, the adoption and expansion of telehealth have provided a silver lining to an otherwise bleak behavioral health landscape. While research is ongoing, sufficient evidence exists to support the effectiveness of telehealth for mental health and substance use disorders.
Reports have found promising potential for issues such as anxiety and depression, alcohol use disorder, and post-traumatic stress disorder. In addition, many of the findings have been comparable to treatment results seen in office-based settings, suggesting that telehealth may successfully reduce the current treatment gap seen in behavioral health settings.
One of the most promising yet challenging issues facing healthcare systems today is addressing behavioral health in the healthcare community. The rapidly changing face of health care demands an efficient set of strategies such as the integration of behavioral health and primary care, community partnerships to expand access, coordination of care through advanced technology, removing stigma, and leveraging telehealth solutions.
These efforts will foster greater patient trust, community awareness, and improved treatment outcomes.