A study done by the Blue Cross Blue Shield of Massachusetts Foundation noted several opportunities for improvement that can increase the effectiveness of community behavioral health centers. Achieving their full promise will require ongoing public education around the services that CBHCs provide. There are solutions that exist that need further scaling and implementation which would ease transportation barriers and address workforce challenges that often prevent patients from using CBHC services when it would be appropriate to do so.
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Any public policy or programmatic intervention requires continual adaptation. CBHCs and other elements of the Behavioral Health Roadmap have brought desperately needed relief to individuals and families and the broader health care system. To maximize opportunities to reduce boarding, adjustments will be needed and should be ongoing.
Kaitlyn Kenney Walsh
President and CEO
Blue Cross Blue Shield of Massachusetts Foundation
Boston
Let’s invest in preventing mental health crises
One key step to reducing emergency department boarding of patients with psychiatric conditions is to prevent the mental health crisis episode in the first place. This can best be done by investing in care in the community and ensuring that treatment is available for conditions before they become crises.
Building mental health service capacity is important so that patients can be readily discharged from hospital emergency departments. Equally important is to ensure adequate reimbursement for our state’s mental health clinics. These clinics form an essential safety net and are struggling to stay in business as MassHealth (Medicaid) reimbursement rates lag and the costs of recruiting and retaining clinicians rise significantly.
Current strategies tend to reallocate the mental health workforce rather than build it. Not only do these clinics help patients of all ages manage myriad mental health conditions, but they are also the training ground for new mental health clinicians. In that way, they actually build system capacity across all care settings.
While MassHealth and commercial health plans cover emergency services at community behavioral health centers, only MassHealth pays for the comprehensive outpatient services there. Commercial health plans should be required to cover the care that keeps patients out of the hospital, and legislation is advancing in both the Senate and the House that would make this happen.
Meanwhile, state cuts to important Department of Mental Health services, including rental subsidies and jail diversion programs, all contribute to an exacerbation of mental health conditions that will continue to put pressure on hospital emergency departments. Investment is needed before the acute mental health crisis as well as after it.
Lydia Conley
President and CEO
Association for Behavioral Healthcare
Framingham