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Report sheds light on U.S. behavioral health crisis

Mar. 23, 2020, 1:21 PM


by Kelsey Herbers

A growing need for behavioral health services compounded by limited access to care has created a health crisis in the United States, according to a report issued by leaders of academic health centers across the country.

The report, created by the Blue Ridge Academic Health Group (BRAHG), brings to light the economic, geographic and psychological barriers preventing those with mental illness, cognitive impairment, psychological distress and substance use disorders from receiving the care they need. It also points to systemic issues with policy, workforce shortages and funding that make the crisis more complex.

Jeff Balser, MD, PhD, President and Chief Executive Officer of Vanderbilt University Medical Center and Dean of Vanderbilt University School of Medicine, is a co-chair of the BRAHG alongside Jonathan S. Lewin, MD, President and CEO of Emory Healthcare and Executive Vice President for Health Affairs at Emory University.

The group, which consists of experts in health policy and practice, seeks to take a societal view of health and health care needs and identify recommendations for academic health centers to create greater value for society.

According to the National Alliance on Mental Illness, one in five adults experiences some mental illness each year, and one quarter of those affected experience serious functional impairment related to their illness. Despite a reduction in stigma associated with receiving care for behavioral health, more than half of those suffering from a psychiatric illness do not receive care.

Insurance coverage for many behavioral health services is either inadequate or unavailable, leaving those who do seek care with high out-of-pocket costs.

Insufficient reimbursement has also led many health care organizations to limit inpatient and outpatient services and salaries for behavioral health professionals, contributing to a workforce shortage and a lack of service availability.

Academic health centers are uniquely positioned to lead nationwide improvements in behavioral health and well-being by advancing education and furthering research, the BRAHG report states.

“As an academic medical center, we are committed to train a mental health workforce for the future (which includes many professionals, not only psychiatrists), to provide excellent care at all stages of mental illness and to gain new insights into the nature of psychiatric disorder,” said Stephan Heckers, MD, MSc, William P. and Henry B. Test Professor of Schizophrenia Research and chair of VUMC’s Department of Psychiatry and Behavioral Sciences.

The BRAHG report recommends leaders of academic health centers consider:

  •  Prioritizing behavioral health by expanding and advancing services
  •  Developing a behavioral health strategy and business plan that meets the needs of patients
  •  Adopting a collaborative care model by integrating behavioral health services into other medical services to improve outcomes and reduce costs
  •  Addressing the workforce shortage by expanding training programs
  •  Building alternative approaches to improve access to care, including telehealth, dedicated psychiatric emergency departments and mobile behavioral health teams
  •  Continuing to invest in basic and translational research
  •  Advocating for policies that provide more comprehensive insurance coverage for behavioral health services, improved enforcement of existing regulations and more funding to expand availability of government-funded services.

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