Barriers that still impede the integration of behavioral and physical health care

The report describes an ongoing mental health crisis in the United States, which has only been exacerbated by the stress caused by the COVID-19 pandemic. (Image: Shutterstock)

As the demand for behavioral health services has increased as a result of the COVID-19 pandemic, various stakeholders are seeking telehealth and digital solutions to not only provide care, but coordinate various types of care and administrative services. A new study from the American Medical Association (AMA) presents a number of recommendations regarding the integration of behavioral health (BHI), with the aim of improving care and expanding coverage through better integration of behavioral and physical health care services.

Related: Has Integrated Health Benefits Reached a Tipping Point?

The report, “Accelerating and Enhancing Behavioral Health Integration Trough Digitally Enabled Care: Opportunities and Challenges,” brought together a range of stakeholders to explore current issues around BHI. Health plans, employers, providers and patients were all represented in the report, which the AMA compiled with help from Manatt Health, a legal and financial consultancy.

A decades-long crisis

The report describes an ongoing mental health crisis in the United States, which has only been exacerbated by the stress caused by the COVID-19 pandemic.

“The number of American adults reporting symptoms of anxiety and/or depressive disorder increased from one in 10 in 2019 to four in 10 at the start of 2021,” the report notes. “In 2018, deaths from drug overdoses were four times higher than in 1999. The prevalence and severity of mental health problems in children and adolescents also increased sharply during this period, with suicide now being the second leading cause of death in people between the ages of 10 and 24.

The report describes how essential it is to integrate behavioral and physical health care, but notes that such integration has faced a number of barriers in the current system.

“The current shift within the U.S. healthcare system toward digital models of care provides a unique opportunity to improve BHI’s overall efficiency,” the report states. “The integration of technology, including digital screening and admission tools, clinical decision support and telehealth care delivery, can support current BHI models by helping to engage more people in the behavioral health treatment and possibly encouraging wider adoption by providers. It is important to note, however, that the adoption of technology-based solutions can increase but cannot replace interactions between providers and their patients. In addition, the persistence of disparities in access to technology, such as high-speed internet or smartphone-enabled devices, may impede equitable adoption of digital BHI.

Ideas on how stakeholders can develop BHI

The report offers a series of ideas on how BHI can be improved by various healthcare stakeholders.

For providers, the report recommends using technology to facilitate the coordination of care between behavioral health providers and primary care teams. Increased training on BHI for all providers and the use of data best practices were also recommended.

For health plans, expanding coverage and implementing payment parity for telehealth services were among the recommendations. The WADA report also pushed for a review of policies regarding copays, prior authorization and other usage management policies.

Employers could improve care coordination in a number of ways, including “whole-person, employer-driven behavioral health programs with care navigation support, [and] intentional culture-driven work to de-stigmatize behavioral health.

The report says employers should also consider entering into contracts with suppliers who adopt BHI. As with insurers, the AMA recommended that employers address the issue of out-of-pocket costs, which can discourage enrollees from seeking care. The study called for a re-examination of how and when to apply cost sharing, especially for behavioral health services delivered in person or via telehealth.

“The demand for behavioral health services is large and growing, but so is the potential of digital technology to support the integrated delivery of physical and behavioral health services,” said AMA President Gerald E. Harmon, MD. equitable treatment of behavioral and physical health needs, and appropriate use of digital health technology can support the integration of behavioral health, especially in times of heightened psychological distress and trauma.

Read more:

About Michael G. Walter

Check Also

European Integration War – Modern Diplomacy

The infamous painting by Eugène Delacroix “Liberty Leading the People” reminds the world of the …