Currently, about one in four adult Americans suffer from a mental
illness each year. Many are negatively impacted by a fragmented system,
insufficient funding for services, too few providers, restricted insurance
coverage, and personal financial barriers.
According to the U.S. Department
of Health and Human Services, in 2012, there were 5.4 million
adults suffering from a mental illness who did not receive any mental health
services. Several reasons were reported, including:
- Inability to afford the cost of care (45.7%)
- Not knowing where to go for services (22.8%)
Now, more than ever, we have an opportunity to improve the quality
of these lives through greater access to better coordinated care.
Beginning in 2014, mental health and substance abuse services are
classified among the ten “Essential Health Benefits” under the Affordable Care
Act. The new health insurance marketplaces cannot apply yearly or lifetime
dollar limits on coverage of these benefits. Nor can insurers deny anyone
coverage or charge more for pre-existing conditions.
Care Act supports new health care delivery models that will better serve
behavioral health patients by coordinating and managing all health care
needs of an individual.
Payment incentives will encourage providers to better manage patients’ transitions among
There are new standards for the quality of
behavioral health care.
Across the country, there is recognition that we cannot separate
behavioral and medical health care. The “mind-body” linkage is critical. Behavioral
health conditions exacerbate physical illnesses, and physical illnesses worsen
In 2013, Pennsylvania’s
Department of Public Welfare’s Office of Mental Health and Substance Abuse
Services (OMHSAS) held statewide forums on behavioral and physical health
integration. There are plans for more in 2014.
OHMSAS wants to assure that the system
is person- and family-centered. HAP has been engaged in several related
discussions, helping to provide guidance to the
state on strategic planning.
The association is
advocating for the use of advanced practice professionals to
practice more fully in the behavioral health care setting to preserve access in
high-utilization and under-served areas.
We are working with behavioral health
navigators to assist hospitals with outreach and enrollment to get coverage for
uninsured behavioral health constituents. And the Delaware Valley Healthcare
Council of HAP serves on the new Community Behavioral Health Kitchen Cabinet to
improve care delivery in the southeast.
As we work to improve access to care for
patients with mental illness, we must add behavioral
and physical health integration to the list. I look forward to being
part of this important discussion.