Experts discuss where Florida stands on substance use and behavioral health services

The intersection between behavioral health, substance use, and public policy has become a regular topic in Florida health care discussions as well as nationwide. State of Reform spoke with members from the Florida Mental Health Advocacy Coalition (FLMHAC) and the Volusia Recovery Alliance, both on the NAMI Florida Board of Directors,  on where Florida stacks up on behavioral health care.

 

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A recent Kaiser Health News story described innovative approaches across the nation that address the opioid use epidemic. The article described a problem many hospital emergency rooms face: 

“A recent report from the Legal Action Center and the Bloomberg American Health Initiative found that despite widespread consensus on the importance of addiction treatment in the ER and an unprecedented rise in overdose deaths, many hospitals fail to screen for substance use, offer medications to treat opioid use disorder or connect patients to follow-up care.”

The story went on to describe innovative treatment programs across the county: substance use treatment navigators in California, a state-funded resource network in New York, and training more health care workers at federally qualified health centers in North Carolina.

In Florida, FLMHAC President Gayle Giese said the implementation of 988, the behavioral health hotline, is their number one issue for next session. The hotline, starting in July 2022, will serve as an alternative to 911 for people in behavioral health crises. Giese said: 

“We want to make sure that Florida’s systems, their call centers, their mobile response teams and their centralized receiving facilities are ready for 988 when it goes into effect, so that we have an effective crisis system [and] so that we are providing a behavioral health response instead of a law enforcement response …

We’re trying to figure out how we’re going to get funding for the call centers and figure out exactly what the lack of capacity is going to be for mobile response teams. I can tell you that in Broward County we need to double what we have already, even before 988 goes into effect.”

Giese also highlighted the importance of certified recovery peer specialists (CRPS), or a person with shared lived experiences to guide someone through the behavioral health recovery process.

“We want to make sure that they get a living wage and benefits so that we can develop a really strong workforce of certified recovery [peer] specialists, and that they are there to provide follow up care when somebody comes out of a Baker Act facility and help the person get their medicines filled at the pharmacy.” 

Ashley Grimes, a CRPS and assistant treasurer for the Volusia Recovery Alliance in east-central Florida, advocated for more research on Medication Assisted Treatment (MAT), and Naloxone (or the market brand Narcan,) as an emergency treatment for overdose. According to Grimes, out of 1300 overdoses in Volusia county this year, approximately 800 people were treated with Narcan. Of those 800, less than 40 died, she said.

“There were over 600 lives in Volusia County saved from Narcan in 2018. There were 700 saved in 2019, and over 800 saved in 2020. That’s a big number in our community.”

Grimes also brought attention to disparities in behavioral health access across the state.

“South Florida has a lot more [resources] available than what we have in [Volusia County] … So the recovery community organizations and the people on the ground have to know the resources in their area, because they have to be able to bring it to their communities.”

Currently, there are 14 certified community behavioral health clinics across Florida, but Giese said she would like to see more. She expressed concern over an April 2021 report by the Agency for Health Care Administration, which found that none of the state’s managed care entities met performance targets for the delivery of behavioral health services. 

 

Image: Agency for Health Care Administration

 

In light of this statistic, Giese also advocates for Medicaid expansion and increased integration of behavioral health services into primary care settings.