Can digital health tools help manage mental health and reduce drug addiction?  - MedCity News

The behavioral health crisis in this country is well documented and only getting worse. As a result, there is a growing eagerness for a paradigm shift that moves behavioral health from the fringes to the forefront of the health and wellness agenda.

One of the most effective ways to achieve this change is to integrate behavioral health more deeply into primary care. This will turn theoretical access into real access, improve overall health outcomes for people with mental illness and/or substance use disorders, improve adherence to treatment recommendations, and reduce overall health care costs. While this benefits all patients, the return on investment is particularly beneficial for our most vulnerable populations.

Despite decades of discussion and active efforts across the country, there is still much work to be done in the health care system to truly integrate behavioral health into primary care. Here are 7 strategies that can move us farther faster.

  • Expand the capacity of the care team

Providers are currently making noble efforts in behavioral health, especially for anxiety and depression. However, access and quality of care can be improved by embedding behavioral health clinicians in the primary care practice. One model might involve bringing in behavioral health clinicians/care managers (such as licensed clinical social workers or psychiatric nurses) and partnering them with a consultant psychiatrist.

  • Increase capacity and expand access through technology

The use of telehealth is a powerful way to expand access and support for behavioral health issues. Other technical support includes peer groups and self-management tools such as mobile apps and other digitally enabled tools. Hybrid in-person/telehealth models can leverage virtual access to behavioral health professionals by having established care team members—such as community health workers—who make home visits, facilitate telehealth appointments with behavioral health professionals who join remotely .

  • Improve infrastructure and processes to facilitate measurement-based care

Primary care providers need effective and easy-to-use tools to help them deliver measurement-based care. The use of standardized tools such as PHQ-9 and GAD-7 screening for depression and anxiety and validated screening tools for substance use disorders can help normalize behavioral health management in routine primary care and increase identification of behavioral health problems. Improved clinical information systems and decision support tools, as well as population health management platforms, can create a strong foundation for integrated systems of care and tracking of key quality indicators.

  • Incorporate home care into your design

Coordinating efforts with home care programs can improve the effectiveness of an integrated behavioral health care approach. Other challenges can be discovered by the team that is in the patient’s home in a way that simply cannot be identified in an office environment. In addition, support at home mitigates problems with accessing care or transportation.

  • Focus on case management resources

If it is possible to identify complex chronic populations in which behavioral health problems exacerbate existing medical conditions, negatively impacting overall health and increasing inappropriate (medically unnecessary) utilization, this may be one area to target care management resources. Emphasis should be placed on ensuring that patients are connected to appropriate resources to meet their complex bio-psycho-social needs and that treatment options offered are evidence-based for substance use disorders as well as problems with mental health.

  • Remove cost barriers for patients

Payment change can unlock delivery change and patient partnership transformation. Health plans should consider other ways to reduce costs, rather than having patients shoulder the cost of accessing behavioral health services. We need to move away from traditional fee-for-service models that encourage a constant focus on the quantity of services provided and toward hybrid payment models that promote better quality of care and effective population health management strategies

  • Make a plan and be patient

Results don’t come overnight. Integration efforts can be divided into immediate, short-term, and long-term goals. The most immediate focus should be on prioritizing access and quality of care. As access improves and stigma is reduced with care embedded in primary care, the conditions will be more consistently identified. From there, the ability to facilitate timely and real access to appropriate care and other resources will be improved, as well as the ability to effectively measure the positive clinical and financial impact that goes beyond improving behavioral health.

In conclusion

We’re seeing unprecedented demand for behavioral health care alongside deteriorating overall health of the US population. As we collectively tackle this rising tide, we will need more payment reforms, more innovation, and a continued migration to more forward-looking payment models and treatment approaches that bring all stakeholders together to care for patients holistically .

This will require the joint participation of all stakeholders. Care delivery must be evidence-based and reimbursement rates must be appropriately calibrated to fund behavioral health services. Value-based models create more opportunities for this integration to happen, but we must continue to push this agenda forward. We need systematic assessment, identification and early intervention. We must ensure that appropriate support is provided and continuously monitor the changing needs of patients while evaluating the effectiveness of our efforts. None of this can happen without a truly integrated model of behavioral and physical health within primary care.

Photo: metamorworks, Getty Images

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