Question

Talking point brief or agenda on improving access and resources for mental healthcare in America

Answer 1

Mental health and substance use disorders a ect peo- ple of all ages and demographics and are extremely bur- densome to society. At least 18.1% of American adults experience some form of mental disorder, 8.4% have a substance use disorder, and about 3% experience co- occurring mental health and substance use disorders.In 2013, health-related spending on mental health disorders in the United States was about $201 billian.Moreover, four of the top ve sources of disability in people 18–44 years old are behavioral health conditions.

People who have more severe behavioral health conditions—such as psychotic disorders, complex bi- polar disorders, treatment-resistant depression, se- vere obsessive–compulsive disorder, and substance use disorders—commonly have or develop such medi- cal problems as diabetes or heart disease and often die early, as much as two decades earlier than the gen- eral population.

Barriers to Service Delivery and Coordination

Payment Models that Reinforce Care Silos and Fragmentation of Care

A Fragmented Care System

An Undersized, Poorly Distributed, and Underprepared Workforce

• New payment approaches that recognize the costs of managing the care of patients who have complex conditions and that encourage the use of teams and technology to identify, engage, and manage the care of such patients.

• Investment in strategies and programs to expand, improve, diversify, and leverage— through technol- ogy and more e cient team-based approaches— the clinical workforce and to develop incentives to improve service in underserved areas.

• Development and implementation of clearly mea- surable standards to encourage dissemination of tested organizational models and to establish a cul- ture of shared accountability to integrate the deliv- ery of services.

• New payment approaches: Develop and apply new payment approaches that provide fair pay- ments that recognize the costs of managing the care of patients who have interacting medical and behavioral health conditions and encourage the use of teams and technology to implement evidence- based strategies to identify, engage, and manage the care of such people e ectively.

• Workforce development: Invest in strategies and programs to expand, improve, diversify, and lever- age—through technology and more e cient team- based approaches—the clinical workforce and to develop incentives to improve service in under- served areas.

• Standards and incentives to disseminate test- ed organizational models: Encourage and invest in improvements in know-how for building better care models, clinical and organizational strategies, and accountability mechanisms to attain better outcomes. Measurable standards must be created to implement incentives to di use tested organi- zational models and establish a culture of shared accountability to integrate the delivery of services.