Five Factors Improving the State of Mental Health Care

November 17, 2015
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Mental illness is a pervasive issue that harshly stigmatizes the millions of Americans who struggle with it every day. Current estimates indicate that about 19 percent of the population — one in five U.S. adults — suffers from a mental illness in a given year. Moreover, of the 20.7 million adults in the U.S. who have a substance-use disorder, nearly 41 percent also have some form of mental illness.

Mental illness is a pervasive issue that harshly stigmatizes the millions of Americans who struggle with it every day. Current estimates indicate that about 19 percent of the population — one in five U.S. adults — suffers from a mental illness in a given year. Moreover, of the 20.7 million adults in the U.S. who have a substance-use disorder, nearly 41 percent also have some form of mental illness.

Behavioral health conditions — which include mental illnesses and substance-use disorders — have a crippling impact on quality of life, yet patients often do not seek treatment. As of 2013, fewer than half of U.S. adults sought and received treatment for their mental health conditions. The impact of these latent issues goes beyond individual quality of life. They impact the workplace and employers’ abilities to remain productive and competitive, and they have extreme financial ramifications on patients, their families, and the health care industry as a whole.

These trends need not continue, however. Improved care coverage, technology integration, employer involvement, provider collaboration and a new social paradigm are all helping to drive change and improve the way mental health care is accessed and delivered.  

Here are five key drivers of change that are improving or promise to improve the state of mental health care delivery, across the country:

  1. Improved coverage and mental health parity: Through the Affordable Care Act, parity requirements for health plans on the individual and small group marketplaces were extended, which means improved coverage of behavioral health conditions for millions of Americans who get their insurance from these exchanges. This move expanded 2008’s Mental Health Parity and Addiction Equity Act (MHPAEA) – which set treatment and financial thresholds for behavioral health care coverage for plans on the commercial insurance market. That parity now applies to those covered by Medicaid and the federal government’s Children’s Health Insurance Program (CHIP).
  2. Apps, online resources and social communities: Through the use of engaging mobile applications, online resource centers and the growing participation in web-based social communities, people are becoming active participants in their health and are able to more easily reach out to find help, support and guidance when they need it. The stigma of mental illness is often a barrier to treatment for those who either don’t feel comfortable discussing the issues with their primary care provider or don’t know how to go about seeking treatment from specialists. Using the vast connectivity of computers and smart phones, people can more easily take the first step toward getting the care they need, as well as reach out to others with similar experiences and conditions for support.
  3. Improved informatics and care technology: Increased technology integration — including the application of data analytics and the use of digital and remote care delivery platforms — is helping to improve population health management capabilities and linking those in need of mental health care to the options available to them. Telehealth solutions, for example, enable patients to receive care wherever they are most comfortable and eliminates the burden of having to travel to a clinic that is far away or inconveniently located. And population health management aided by data-rich informatics can reveal previously undiagnosed behavioral health issues in certain populations, making possible better, targeted treatment. Behavioral health care providers are not currently included under federal incentives to adopt electronic health records, but there is a building consensus that adoption of such technology will improve care for those with behavioral health conditions.  
  4. Employer action: Employers, who provide health care coverage for approximately 50 percent of the U.S. population, know how behavioral health issues can impact workplace productivity and workforce innovation. Twenty-five percent of the nation’s working population has a diagnosable behavioral health condition. Half of all employees need help managing stress. Up to 40 percent of missed work time is due to a behavioral health issues. Employers are warming to the idea of improved employee health care benefit options, and also increasing the use of integrated solutions for better screening of potential mental health care issues and to provide their employees easier access to treatment options. More movement of this type by employers stands to improve workforce health, better enable treatment, and improve the state of mental health care delivery overall.
  5. Collaboration between primary care and behavioral health: Primary careproviders are typically the first step anyone takes toward getting health care. These clinicians often can spot behavioral health issues, and if the mechanism existed, could connect patients with specialists who can deliver that type of care. But all too often, primary care doctors and behavioral health providers operate in silos. Care teams lack integration, but with better care coordination, communication and the application of technology to specifically address these issues, collaboration becomes possible, as does improved mental healthcare delivery.

Changes in laws and regulations can drive improvements in behavioral health care, as can advances in technology and strategies for using the mountains of data that technology produces. But plain old communication among all stakeholders in the promise of better mental health for all Americans – patients, families, employers, community leaders, and especially the clinicians and other caregivers across the whole spectrum of health care – perhaps offers the most hope for positive change.

You can connect directly with Cynthia Telles on Twitter.