According to the Journal of American Medical Association, nearly 1 in 5 people in the U.S. are afflicted with some form of mental health condition. If this trend isn’t concerning enough, the Health Resources and Services Administration reported in 2016 that the supply of select behavioral health professionals is 250,000 short of what the nation’s demand will be by the year 2025. Not surprisingly, as the situation worsens over time, primary care physicians will have to shoulder the burden.
Long waiting lists for mental health services are nothing new in many communities across the U.S., and the unfortunate aspect is that many of these patients are giving up on treatment rather than waiting.
“I often have a patient who clearly needs to see a psychiatrist, but is unable to get an appointment for another six months!” -Dr. G., New Jersey
In other instances where mental health access is available, insurance plans with notoriously low coverage options are making it difficult for patients to get the coverage they need.
One positive development, although it is also contributing to the demand for mental health services exceeding supply, is that awareness efforts nationwide are lessening the social stigmas attached to mental health issues. Further, the clear relationship between mental health and physical health are changing both attitudes and approaches to healthcare delivery in clinics and practices nationwide.
One model in practice, referred to as SBIRT (Screening, Brief Intervention, and Referral to Treatment), originated through a 2009 North Carolina Medical Journal paper.1 Research from that paper identified that approximately 70% of all primary care visits could be attributed to behavioral or mental health issues. If nothing else, these staggering numbers clearly demonstrate the need for additional mental health services training in the primary care setting, but also the necessary linkage to mental health providers and services.
A 2016 Ohio State University College of Medicine study 2 concluded that while mental health screenings are important in primary care settings, additional training and education for providers on mental health issues and medications is critical. Additionally, providers need to be more cognizant of the community mental and behavioral health services that are available and to ensure they are maintaining those relationships to key services for their patients.
“Innovative ways of creating access to mental health services include telepsychiatry, where the psychiatric resource is brought to the patient, rather than the other way around.” -Dr. H., Wisconsin
In many rural communities, the availability of mental health services is often a multiple hour drive away. In these circumstances, providers are relying on technology to create accessibility to services. The utilization of telemedicine technology provides a platform for mental health care providers to evaluate, treat, and manage medications for their patient at a distance. Integrating that care in consult with the primary care physician or family practitioner allows them to work together and achieve better results.
As with every challenge that ultimately crops up within the healthcare industry, the solutions require multi-faceted approaches that are supported from the federal level on down through the state and local level. In many cases, the best solutions will originate at the local level and work up as opposed to down from the federal government. At the federal level, legislators need to create more incentives for healthcare professionals to follow a mental health services tract, insurance companies must reinforce their subscriber’s ability to seek treatment by providing the coverage necessary and also to reimburse at appropriate levels. Locally, community leaders, physicians, and educators need to foster the linkage between physical care providers and mental health providers ensuring that those individuals that need treatment are referred consistently to the appropriate entity where they can receive the help they need.
1 Collins, Chris, North Carolina Medical Journal, “Integrating Behavioral and Mental Health Services into the Primary Care Setting”, 2009.
2 Murray, Kelsey, Ohio State University College of Medicine, “A Survey of Mental Health Needs in a Primary Care Setting”, 2016
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