The American Hospital Association Leadership Summit brought together health care leaders from across the country to share strategies to achieve transformation in the most critical areas. In a session titled “The Behavioral Health Crisis Won’t Change — Unless We Do”, presenters from Advisory Board and ChristianaCare shared key insights into how intertwined behavioral health is with many of health care’s challenges and how we can start to solve them.
The need for behavioral health has never been higher as the presenters pointed out:
- Increased need. 33% of adults reported symptoms of anxiety or depression in June of 2022 compared to 11% in June of 2019.
- Increased demand. There has been a 51% increase in adolescent psychology patients since March of 2020.
- Inadequate supply of providers. 60% of psychologists reported having no openings for new patients in 2022.
- Negative outcomes. There was a 109% increase in median monthly overdose deaths among youth and adolescents ages 10-19 from 2019 to 2021.
Erin Booker, ChristianaCare’s Chief Biopsychosocial Officer, shared that even her providers experience access issues as they are hesitant to schedule a behavioral health appointment that could be used by one of their patients.
How Do We Make Progress in This Crisis?
Advisory Board spent a year researching the root causes of the behavioral health crisis and found that underinvestment has led to compounding barriers and created conditions for self-reinforcing structural issues.
They identified 5 root causes:
- Stigma toward people with behavioral health conditions.
- Unaddressed social determinants of health.
- Insufficient research around behavioral health conditions and treatments.
- Low reimbursement rates for behavioral health care services and providers.
- Behavioral health clinician shortage.
These root causes are Intertwined and consistently reinforce each other. There is long standing stigma toward behavioral health – both in an individuals’ inclination to access it, and our willingness as a society to invest in research. The lack of research to prove its efficacy drives lower health plan reimbursement rates, and fewer clinicians go into the specialty because of the challenging landscape.
While Erin Booker recognizes the challenges are significant, she shared how ChristianaCare is moving the needle on these issues. Behavioral health is not just its own service line – when it’s incorporated into all of health care it can be proactively addressed. She pointed out that you don’t get an annual physical when you’re ill – it’s preventive. Psychological wellness should be treated the same way. In addition to screening for mental wellness, her organization is focused on alleviating social determinants of health that can have a serious impact on mental health. Take this example: if a patient needs surgery but does not have transportation, they may not have the surgery leading to chronic pain and depression. These factors are all intertwined, so delivering holistic care is essential.
She also highlighted the need for policy change and a focus on data. She shared how through policy change, annual psychological wellness screenings are a standard part of care in Delaware, and they can be billed for reimbursement. That lowers a significant barrier to delivering this important preventive care. They are also collecting data so she can build the business case, demonstrate the downstream financial and societal impact of behavioral health care, and sustain support and investment for her programs.
Avoid an All or Nothing Approach
In closing, the presenters encouraged attendees to do something, even if it’s not a perfect solution. There are many ways to start lowering barriers, bridging gaps in care, and lessening the impact of today’s crisis. They pointed out that every sector in this ecosystem can help remove the root causes and encouraged attendees to work independently and in partnership with other healthcare stakeholders to create real change.