Big Topics in Small Doses Episode 1: Mental Health
Access, Equity, Advocacy:
Closing the Gap in Mental Health Care
New Opportunities Open the Door to Mental Health Reform
By Don Antonucci, Senior VP of Growth, Blue Shield of California
With today’s turbulent economy, high-stress careers, and the pandemic’s impact on our daily lives, a growing number of health experts see mental health as a critical unmet need. Just look at the statistics. In the U.S., Mental Health America estimated that 44 million people suffer from mental and behavioral health issues, and each year the Substance Abuse and Mental Health Services Administration projects that roughly one in five adults will have a diagnosable mental health condition. Whether it’s anxiety, depression, addiction, or another adverse disorder, the demand for equitable mental health care is clear.
As host of Healthy Dose of Dialogue podcast, I’ve enjoyed speaking with health professionals, entrepreneurs, and thought leaders about mental health’s evolving landscape. These discussions highlighted game-changing opportunities to increase access to high-quality mental health services.
Patrick J. Kennedy, former U.S. House of Representative and founder of The Kennedy Forum, is a strong advocate that mental and behavioral health care have the power to solve some of the country’s most vexing physical and societal ailments. These issues include everything from incarceration rates to homelessness to drug addiction.
“It’s the truth: Our system of healthcare is not acculturated to treat mental health and addiction in the same way it treats other physical illnesses, but that’s changing,” Patrick said. “All of us, collectively, including the biggest payer of all which is the federal government, have an interest in getting in early to pay for these things—which may not be incentivized in the current financial reimbursements system.”
Patrick was the lead sponsor of the 2008 landmark Mental Health Parity and Addiction Equity Act, a law that requires insurers to cover treatments for mental health and substance abuse. In our conversation, he described the act as a foundational first step for accessible care, hopefully opening doors for public and private support. “This really is about health equity. In a sense, the Parity Law was a medical version of civil rights. It’s basically saying people who suffer brain illnesses shouldn’t be taken care of in a substandard way when compared to their other physical illnesses,” he said.
Some of the chief obstacles between mental health and physical health care are the different payment models for each. Few know this better than Suzanne Delbanco. As executive director for the health advocacy group Catalyst for Payment Reform, Suzanne spoke to me of the many patients limited by a lack of mental health options within their primary care. “When it comes to both mental health and substance abuse disorders, there hasn’t been much experimentation with new payment models,” Suzanne said. “Yet there is obviously a big movement to try to integrate the behavioral health needs of patients with primary care, or the rest of their care, and paying in siloes perpetuates some of those siloes.”
During the COVID-19 outbreak, she explained that her organization noticed the problem only intensified. “Before the pandemic, our members were already seeing an increasing need, quite steep, for both mental health and substance abuse disorder care, so this pandemic has just exacerbated that need and also created challenges, but also opportunities for how to deliver that care.”
Tracy Watts, a senior partner and U.S. Leader for Healthcare Policy at Mercer, has urged employers to take a holistic approach when choosing health policies, factoring in mental health services. Tracy said she’s noticed telehealth has proven to be an innovative tool and enabled mental health providers to deliver services between states.
“It’s really about access,” Tracy noted. “We have a real shortage of mental health providers. I think the telemedicine programs specifically for mental health have become very effective. More and more employers are taking advantage of those. I also think that some of the work being done just on the pure telemedicine side to allow providers to cross state lines will have an impact on [increased] access to behavioral health services.”
For Naomi Allen, co-founder and CEO of the pediatric behavioral health provider Brightline, telemedicine represents a critical tool for children and teens. Her company specializes in virtual care, and Naomi said that for many families, telehealth is their only option since 75 percent of counties lack pediatric behavioral health clinicians.
“Historically, no one has figured out how to support a therapy model for kids using digital interventions,” Naomi said. “The fact we’ve built this solution in an evidence-based, high-quality protocol, virtual-care model means kids in these counties with no clinicians can be supported.”
Listen to the full episodes by clicking the links below:
Naomi Allen, Co-founder and Chief Executive Officer of Brightline (full episode)
Tracy Watts, Senior Partner and U.S. Leader for Healthcare Policy at Mercer (full episode)
Suzanne Delbanco, Catalyst for Payment Reform Executive Director (full episode)
Patrick J. Kennedy, Former U.S. House of Representative and Founder of The Kennedy Forum (full episode)