The U.S. is experiencing a behavioral health crisis.
Challenges include rising demand for care, lack of capacity and staffing, unreliable and untimely data, and fragmentation in care delivery.
During a roundtable session sponsored by Bamboo Health as part of Becker's Hospital Review's 12th Annual Meeting, Nishi Rawat, MD, chief clinical officer for Bamboo Health, led a group of healthcare executives in a discussion about how their organizations are responding to this crisis.
Four insights from the session:
1. America is experiencing a wide-reaching behavioral health crisis. According to Dr. Rawat, this crisis has been exacerbated by the pandemic and is affecting adults, teens, and children. Dr. Rawat said opioid overdose deaths and suicide rates are alarmingly high. One participant said the capacity of his health system's 24-bed pediatric inpatient psychiatric unit is inadequate as it had 160 kids with mental health issues on medical floors in February.
Other challenges cited by roundtable participants include more aggressive patients, staffing shortages, rising labor costs, and lack of reimbursement. "So many insurance companies don't pay for mental health or don't pay at par with medical conditions," one participant said. "Even our Medicaid system doesn't do a good job." Another participant added, "It is a broken system."
2. The government is taking action to assist, but care coordination issues remain. In 2020, the FCC (Federal Communications Commission) designated "988" as a new three-digit, easy-to-remember number to connect to the National Suicide Prevention Lifeline, to go into effect July 2022. This is analogous to 911 for mental health. The goal is for every caller to get a definitive assessment and access to treatment. Currently, calls are routed to around 200 regional crisis centers. States are responsible for staffing call centers, putting protocols and quality control in place, and preparing to dispatch mobile crisis teams. When a person calls 988, they will be triaged to the appropriate level of care. "Think of this as emergency departments for behavioral health conditions," Dr. Rawat said. Every state is racing to set up the clinical infrastructure. As part of the triage process, organizations need situational awareness regarding the availability of inpatient and outpatient treatment facilities. Dr. Rawat said Bamboo Health is helping some states create the necessary infrastructure through their Crisis Management Solution.
3. Health systems are innovating to increase access to and awareness of behavioral health. While the pandemic increased the demand for mental health treatment, the U.S. also saw an increased use of telehealth to deliver care and a cultural shift with behavioral and mental health being destigmatized. One participant noted that while health system fundraisers often celebrate the newest cancer wing or surgical center, her facility's most recent annual gala was devoted to behavioral health, reflecting a change in culture. "The mindset is shifting," she said.
Organizations are innovating to increase access to behavioral health treatment. One participant said his organization partnered with schools to provide access to mental health clinics to students and families. A different physician based in the Midwest said his organization partnered with an internet provider to deliver services to underserved populations to help families receive the necessary access to mental and behavioral health treatment.
4. Bamboo Health uses technology to help providers and payers manage substance use disorder and mental health conditions. Bamboo Health provides the prescription drug monitoring software used in 44 states. Use of this software is correlated with a reduction in prescribing and dispensing of opioids, according to Dr. Rawat. Bamboo Health's Pings solution provides real-time notifications with contextual information to facilitate care coordination whenever patients receive care across the continuum. OpenBeds is a solution that facilitates access to mental health and substance use disorder care. Bamboo Health provides data, analytics, and tools to help clinicians and patients better access behavioral health treatment.
The need for access, awareness, and resources to be funneled to behavioral health is greater than ever. Leveraging data, analytics, and solutions from companies like Bamboo Health can equip providers and payers to better meet this rising demand.