Hearing Testimonies Tout Benefits of Mental Health—Primary Care Integration

The Senate Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held a hearing to discuss mental health treatments and services. Witnesses from various healthcare, mental health, and law enforcement agencies discussed the progress they had seen and further steps needed to address the problem of mental illness in America.

Presiding Senator Roy Blunt, R-Missouri, began the hearing by stating that Congress has undertaken a “renewed commitment to do more” to help the millions of families impacted by mental illness. He explained that the hearing would provide the opportunity for senators to ask experienced stakeholders about best practices and recommendations for improving mental healthcare.

The first witness, Joseph Parks, PhD, explained that his experience came from managing health budgets as the Medicaid director in Missouri, delivering care as a staff psychiatrist at the Missouri Institute of Mental Health, and having family members who struggled with mental illness. He said that health reform has left out behavioral healthcare, which doesn’t have the workforce and funding to keep up with the advances in primary care. Parks called for the implementation of payment innovations that would allow community mental health centers to continue providing services, and recommended that the Mental Health Parity and Addiction Equity Act be protected and expanded.

Next up was David M. Johnson, EdD, LMHC, chief executive officer of Navos Mental Health Solutions. Johnson discussed the advances in mental health service access he has seen under the Affordable Care Act (ACA), which he said has “dramatically improved millions of lives.” Due to Medicaid expansion, community mental health centers can provide evidence-based treatments that promote wellbeing and address the social determinants of health, which ultimately save costs. If the resources allotted by the ACA decreased, he predicted fewer people would receive treatment, which would lead to higher spending due to increased homelessness and institutionalization.

Dennis S. Freeman, PhD, pointed to the accomplishments of Cherokee Health Systems, where he is the chief executive officer. He explained how the company has blended mental health into their primary care teams and processes, ensuring that “behavioral health is a factor in every primary care visit.” An integrated medical home is the ideal setting for care of patients with complex needs, as it can reduce the barriers to accessing necessary behavioral services, he said.

Chief Donald W. De Lucca, president of the International Association of Chiefs of Police, outlined several steps that have improved the law enforcement community’s response to mental illness calls. He explained that efforts to “avoid the criminalization of mental illness” have included the training of police officers on mental health first aid and crisis intervention techniques. One successful pilot program had officers set up video chats on a tablet to connect offenders with mental health professionals instead of arresting them.

A common theme throughout the testimonies was the need for more funding to support these interventions and strengthen the depleted behavioral health workforce. The individuals testifying argued that by allocating funds for prevention and early intervention, governments could actually save money. With a focus on more efficient treatments and solving the underlying conditions that cause mental health crises, unnecessary emergency department visits and hospitalizations could be prevented.

Managed care organizations used to be viewed as adversaries that just said “no” to every request, said Johnson, but that perception has drastically changed. They now understand that “working together in very practical ways” with community mental health providers can avoid larger healthcare costs down the road. He gave examples of how managed care organizations have funded peer support specialists, wellness initiatives, and in-home treatment via smartphones and mobile applications so they could eventually “share the savings” with the behavioral healthcare teams.