Prominent public officials, including President Joe Biden and Gov. Jay Inslee, have identified behavioral health care as a priority service, and some experts discussed how they’re making progress on it in Washington at the 2022 Inland Northwest State of Reform Health Policy Conference.
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Psychologist Dr. Noelle Turner, from Mica Peak Psychology & Consulting, was one of the panelists on the conference’s “An honest conversation on the future of the behavioral health system” panel.
“I want to talk about integrated primary care or primary care behavioral health,” Turner said. “And the reason I’m passionate about this is that it combines medical and behavioral services for problems patients bring to primary care, including stress, physical symptoms, health behaviors, mental health, substance use disorders. For any problem, there’s no wrong door.”
Behavioral health services are in great need, but some who need care have trouble accessing them. Primary care physicians (PCPs) have voiced concerns about the issue, Turner said.
“What we know is that 46% of adults will have mental health or substance use issues at some point in their life,” Turner said. “And that number has actually increased with the pandemic. We also know that 20% of primary care visits are for mental health or substance use issues alone, and that’s where I see primary care behavioral health shine. Of those 20% of PCP visits that are just for mental health and substance use concerns, when PCPs were surveyed, about two-thirds of them said they can’t get access to mental health care for their patients. [They’re] ready to do something and they can’t get them into care.”
Jeff Thomas, CEO at Frontier Behavioral Health, also participated on the panel. He identified telehealth, which was widely used during the pandemic, as an effective way to offer increased behavioral health services.
“We’re going to continue to expand the use of technology and services delivery,” Thomas said. “Telehealth is here to stay. Exactly how that will look is still being figured out as the [public health emergency] order kind of ages out. There is a place for it in our world for sure.”
Thomas said interoperability will be important so providers can share information through electronic medical records and have as much information on patients as possible.
“By the end of this year we’ll have interoperability with each of our primary care providers,” Thomas said. “It’s such a fantastic development. Community information exchanges are being explored. I think there will be some headway on that. That has to do with essentially having ways in which there can be portals for referrals and closed-loop referrals to social determinants of health providers.”
Another way to increase care is through further expansion of [community-based] inpatient treatment, Thomas said. He noted that several Department of Commerce grants have been distributed through the Behavioral Health Facilities program to expand services at behavioral health facilities. That could help those facilities prepare to care for patients who are ready for discharge at hospitals, but have been unable to secure placement at other health care organizations.
Jess Molberg, Senior Director of Behavioral Health at Coordinated Care, participated on the panel as well. She said more step-down investments could help address the issue.
“You’re seeing people staying in acute settings longer,” Molberg said. “We need those step-down places so people can continue their wellness journey. There is no blanket approach for this.”
Some states use qualified mental health professionals (QMHPs) to reach more patients, which could be useful in Washington, Molberg said.
“They go out into the community,” Molberg said. “They also sit at the clinics. If you can’t see your counselor, you can see this QMHP.”