4 Strategies to Increase Access to Behavioral Health

Chronic problems prevent people from accessing mental health care in the United States today, despite the great need for these services. But significant opportunities for improvement exist through the expansion of evidence-based practices, according to The Brookings Institution. With support from The Pew Charitable Trusts, researchers interviewed behavioral health professionals, practitioners, and stakeholders and conducted an environmental survey of existing literature to identify these trends. evidence-based and how it is used.

“There is a mismatch between the strategies that research shows are likely to benefit people and the availability of strategies that people can benefit from,” the researchers found.

Brookings examined these policies through the lens of several policy issue areas, including crisis management.

Behavioral health interventions and support must be timely, whether for expected events such as prison release and childbirth, or unexpected, such as mental health problems or events early psychosis. These rare events require a unique ability to respond, often outside the normal clinical setting, and with methods to connect patients to the following services.

At the core of capacity building is strengthening the care process, which can support a person from their first point of contact (such as calling the emergency services for help) and anyone who responds throughout the process of tracking services. Key approaches include investing in staffing and case management, technology to support those efforts, and payment solutions to improve local efforts.

Local governments often struggle to fund mental health care because services are divided into many areas, including correctional, mental health, and substance abuse services, with varying funding and less interaction between them. This creates the problem of “wrong pockets”, which occurs when one department or institution incurs costs while another is reaping the benefits, removing incentives to improve. For example, financial savings resulting from investments in community behavioral health centers are often realized by local police and emergency departments, making the funding model unstable for the centers. of life itself.

Local governments can integrate financial systems with support for better data sharing across systems, and technical assistance from donors in understanding financial challenges across sectors and jurisdictions. . For example, Ohio has 50 Alcohol, Drug Addiction and Mental Health Boards, which plan, develop, fund, regulate, and evaluate mental health and addiction services. community across organizations and departments across the country.

Fixed incomes may present significant obstacles to any expansion of behavioral health services, but short-term opportunities may pave the way for larger expansions over time.

Crisis programs​​​​​​​​​​​​​​​​​​require three new types of resources: an emergency line (such as 988 Suicide & Crisis Lifeline), crisis response teams to respond, and referral resources for emergency services. stability or compliance. Each sector has complex staffing and funding needs, and until government grants and policies are adjusted to coordinate these services with ongoing care, scaling up may not be possible. Meanwhile, state and local governments have the opportunity to use pilot programs to determine what will work for the communities they serve. As funding becomes available, government officials will prepare to scale these promising pilot programs into larger solutions.

In addition to adjusting existing funding systems, local governments can also find short-term solutions, including government grants and/or donations, to strengthen their maintenance operations. For example, the government may use private grants to cover the initial costs of building a crisis unit, then rely on Medicaid, Medicare, and private insurers for payment once the service is complete.

In short, providing comprehensive disaster care has proven to be a challenge for national and local governments. Increased collaboration across sectors and investment in local efforts can improve health outcomes for all.

Julie Wertheimer is project director of the mental health and justice project of The Pew Charitable Trusts and Brandee Izquierdo, Ph.D., is director of Pew’s behavioral health programs.