behavioral health integration

Behavioral Health Integration 2013 in Review

2013 has been a very good year for Behavioral Health Integration Blog! Our popular Integrated Care Thought Leader Series began this year, providing insights into the minds of some of the most prominent thought leaders in integrated care, including Dr. Alexander “Sandy” Blount, Dr. Benjamin Druss, Larry Fricks, and Dr. Benjamin Miller. Stay tuned in 2014! We have several excellent integrated care thought leaders lined up, to provide their expert perspectives on whole health and integrating behavioral health and primary care for enhancing health outcomes, reducing healthcare costs, and improving access to healthcare.

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 4,800 times in 2013. If it were a NYC subway train, it would take about 4 trips to carry that many people.

Click here to see the complete report.

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Affordable Care Act · behavioral health integration · health care reform · Integrated Care

Historic Parity Ruling Provided at Long Last

“We know so much more today, and yet the problems are still very much the same, with one exception: Recovery.  Twenty five years ago, we did not dream that people might someday be able actually to recover from mental illnesses.  Today it is a very real possibility.”  ~Former First Lady Rosalynn Carter

History was made today at the Carter Center in Atlanta. Health and Human Services Secretary Kathleen Sebelius made a long-awaited announcement at the 29th Annual Rosalynn Carter Mental Health Policy SymposiumHealth insurance companies must cover mental illness and substance abuse just as they cover physical diseases. Secretary Sebelius’s speech  may be read here in its entirety.

In 2008, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, marking an important step forward in efforts to end discrimination in insurance coverage for mental health and substance use disorder treatment. While the act closed several loopholes left by the 1996 Mental Health Parity Act, it has taken five years to finalize the law. The 2008 act lacked clarity on how parity is to be achieved, particularly when treatment involves intensive care at physician offices or long-term hospital stays.

Today’s ruling provides clarification on how parity applies to residential treatments and outpatient care. It also ensures that copayments, deductibles, and limits on mental health benefits are not more restrictive or provide less coverage than those for medical and surgical benefits, including geographic or facility limitations. These have been tremendous barriers to treatment thus far and represent a significant triumph for the behavioral health community.

“This is the largest expansion of behavioral health coverage in a generation,” declared Secretary Sebelius. Addressing the need for adequate care for mental health has been a goal for more than 50 years, when President John F. Kennedy signed the Community Mental Health Center Act of 1963 into law.

At long last, treatment for behavioral health disorders is regarded as equal to other types of healthcare. This represents a significant achievement in behavioral health and should contribute to the ongoing effort to reduce the stigma. Millions fail to follow up with needed treatment because of stigma. With this final ruling and with movement toward integrated care, we will finally be able to improve access.

What will the world be like when people begin to actually receive that needed treatment?

behavioral health integration · Integrated Care

Celebrate Mental Illness Awareness Week, World Mental Health Day, and National Depression Screening Day

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Celebrate World Mental Health Day 2013

This is Mental Illness Awareness Week and today has been designated as both World Mental Health Day and National Depression Screening Day. Social media has numerous posts this week promoting mental health awareness and related topics as we try to educate the general public. We strive for increased awareness of the importance of good mental health as well as the challenges related to the stigma surrounding mental illness.

Integrating mental health and substance use disorder treatment with primary healthcare provides the opportunity to both increase awareness and decrease the stigma associated with behavioral health issues. Integrated care helps to improve access, reduce costs, and improve outcomes. Integrated care is better care!

In 1990, the U.S. Congress established the first full week of October as Mental Illness Awareness Week (MIAW) in recognition of the National Alliance on Mental Illness’s (NAMI) efforts to raise mental illness awareness. Since then, mental health advocates across the country have joined with others in their communities to sponsor activities, large or small, for public education about mental illness.

Today, 10/10/13, is designated as World Mental Health Day. This year’s theme is “Mental Health and Older Adults.” The day is celebrated at the initiative of the World Federation of Mental Health (WFMH) and the World Health Organization (WHO) supports this initiative through raising awareness on mental health issues using its strong relationships with the Ministries of Health and civil society organizations across the globe.

Today is also National Depression Screening Day. National Depression Screening Day raises awareness and screens people for depression and anxiety disorders. NDSD is the nation’s oldest voluntary, community-based screening program that gives access to a validated screening questionnaire and provides referral information for treatment. More than half a million people each year have been screened for depression since 1991.

Let us work together to promote good mental health locally and around the world.

Affordable Care Act · behavioral health integration · healthcare integration · mental health

The Role of Integrated Care in Mental Health: Mental Health Blog Day 2013

Blog for MH 2013

I’m happy to be participating in blogging for mental health today. I’m joining in on this year’s blog party because mental health awareness is so important. Each mental health blogger has a unique perspective, addressing important topics such as awareness, recovery, wellness, public policy, services, co-occurring mental health and substance use disorders, etc., providing a personal, professional, or business perspective – or any combination of the three. These interesting and informative mental health blogs will provide an abundance of good reading for blog connoisseurs today!

Integrated care, a whole-health approach to healthcare, plays a very important role in mental health. This perspective has been gaining more and more attention over the past decade or so. It is not uncommon for people who receive mental health treatment to have little or no coordination of services with their primary care provider. Conversely, many people seeking primary care services have unmet mental health and/or substance use disorder treatment needs. This lack of coordination frequently results in sub-par outcomes, yet is often much more expensive as a result of duplicate or counter-indicated procedures and treatment. Lack of coordination results in costly emergency department visits, providing episodic treatment rather than a much more effective chronic care regimen and focus on prevention.

In my last post, I suggested that Integrated Care Awareness Day be recognized during Mental Health Month. As we increase awareness of the need to focus on healthcare in a holistic way, we begin to change the perception of mental health, not only for healthcare providers and policy-makers, but also for the public at large. Through improving access to services, controlling healthcare costs, and through tracking and improving health outcomes, we as a society can transition toward a wellness approach in healthcare.

Access to Services

Stigma is a huge barrier to receiving mental health services. Integrated care allows people to access services through mental health providers or primary care providers. They have the choice to receive mental health services where they are most comfortable.

Controlling Healthcare Costs

Coordination of care and focus on prevention help to control overall healthcare spending. The Affordable Care Act has provided the opportunity for changing the way that healthcare is delivered. Medicaid Health Homes are an example of this.

Improving Health Outcomes

Making use of health information technology enables providers to track outcomes, develop disease registries, and to share information for enhancing the coordination of care. As a result, people have improved health outcomes. They are healthier.

I hope you will stop by again soon. The next several posts to come will be a Thought Leader Series, a conversation with the visionary leaders who are instrumental in developing integrated care through research, policy, practice, and their steadfast passion for improving the lives of so many.

Happy Mental Health Blog Day 2013!

Affordable Care Act · behavioral health integration · mental health

May is National Mental Health Awareness Month: Let’s Include Integrated Care Awareness Day

On 4/30/2013, President Obama became the first president to sign a proclamation declaring May as National Mental Health Awareness Month. “As a nation, it is up to all of us to know the signs of mental health issues and lend a hand to those who are struggling,” he said. “Shame and stigma too often leave people feeling like there is no place to turn. We need to make sure they know that asking for help is not a sign of weakness—it is a sign of strength.” (Click here for a full copy of the Presidential Proclamation – National Mental Health Awareness Month, 2013.) This endorsement and recognition are important steps toward acceptance of mental health. However, mental health and physical health are inseparable. And as more healthcare providers provide integrated services, issues of shame and stigma are reduced, thus creating an environment in which asking for help becomes less difficult. The Affordable Care Act has provided numerous opportunities for the integration of behavioral health and primary healthcare.

Mental Health Awareness Month began in 1949 through the vision of Mental Health America to raise awareness about mental illness and the need for services. This year’s theme is Pathways to Wellness:

Key Messages

  1. Wellness – it’s essential to living a full and productive life. It’s about keeping healthy as well as getting healthy.
  2. Wellness involves a set of skills and strategies that prevent the onset or shorten the duration of illness and promote recovery and well-being. Wellness is more than just the absence of disease.
  3. Wellness is more than an absence of disease. It involves complete general, mental and social well-being. And mental health is an essential component of overall health and well-being. The fact is our overall well-being is tied to the balance that exists between our emotional, physical, spiritual and mental health.
  4. Whatever our situation, we are all at risk of stress given the demands of daily life and the challenges it brings-at home, at work and in life. Steps that build and maintain well-being and help us all achieve wellness involve a balanced diet, regular exercise, enough sleep, a sense of self-worth, development of coping skills that promote resiliency, emotional awareness, and connections to family, friends and community.
  5. These steps should be complemented by taking stock of one’s well-being through regular mental health checkups and screenings. Just as we check our blood pressure and get cancer screenings, it’s a good idea to take periodic reading of our emotional well-being.
  6. Fully embracing the concept of wellness not only improves health in the mind, body and spirit, but also maximizes one’s potential to lead a full and productive life. Using strategies that promote resiliency and strengthen mental health and prevent mental health and substance use conditions lead to improved general health and a healthier society: greater academic achievement by our children, a more productive economy, and families that stay together.

As we focus on the importance of good mental health, it’s also an opportune time for increasing awareness of the importance of focusing on whole health rather than segregating mental health and substance use disorder issues. Contrary to popular belief, mental health services are largely provided outside of the mental health system. According to the Milbank Memorial Fund report, Evolving Models of Behavioral Health Integration in Primary Care, as many as 70 percent of primary care visits stem from psychosocial issues. While patients typically present with a physical health complaint, data suggest that underlying mental health or substance abuse issues are often triggering these visits.

According to the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, Mental Illness Surveillance Among Adults in the United States Supplements 9/2/11 – 60(03);1-32:

Mental illness exacerbates morbidity from the multiple chronic diseases with which it is associated, including cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer (12–16). This increased morbidity is a result of lower use of medical care and treatment adherence for concurrent chronic diseases and higher risk for adverse health outcomes (17–20). Rates for injuries, both intentional (e.g., homicide and suicide) and unintentional (e.g., motor vehicle), are 2–6 times higher among persons with a mental illness than in the overall population (21,22). Mental illness also is associated with use of tobacco products and alcohol abuse (23).

May has 31 days, so perhaps we can designate one of the days in May as Integrated Care Awareness Day. A day set aside to bring awareness of the benefits of looking at one’s health as a whole rather than segregating mental health from physical health. With this year’s theme, Pathways to Wellness, it is an ideal time to increase awareness.

“The body must be treated as a whole and not just a series of parts.”
– Hippocrates (460 BC – 380 BC)

behavioral health integration

A Tragedy in Connecticut: We Are In This Together

We at Behavioral Health Integration Consulting are devastated by the tragedy at Sandy Hook Elementary School. Our hearts go out to the families, friends, coworkers of the innocent lives that were senselessly lost. There is no solace, no answers for the innumerable questions. We honor the memories of the heroes who died so that others could live.

All across the US…and across the world…mothers, fathers, grandparents, friends, grieve for the loss of the children they have never met. We share in your grief. Collectively we mourn…because we all recognize that this could easily have been our children, our friends, our coworkers lost. The atrocities happened to all of us. We are in this together.

We want to share Mahatma Gandhi’s “Prayer for Peace” as a small offering of condolence:

Prayer for Peace - Mahatma Gandhi

In addition, we pledge to work diligently with healthcare providers across the country to make behavioral health services more accessible for people in need. In lieu of funding limitations and ongoing cuts to state behavioral health services, the logical solution is to promote the integration of behavioral health and primary care services. Via healthcare reform and healthcare policy, we shall succeed in our mission.

Blessings to all of you from all of us at Behavioral Health Integration Consulting.