Sadly sustainability and innovation are not terms that easily describe our nation’s mental health care. Lack of financial investments from insurance companies are at the core of the barriers preventing innovation in this health sector.
In a recent report published in JAMA-data from 2012-2017, the researchers identified 3.2 million adults with mental health conditions, 294,550 with alcohol use disorders, 321,535 with drug use disorders, 178,701 with heart failure and nearly 1.4 million with diabetes with coverage under employer-sponsored insurance plans.
Patients with behavioral health conditions were more likely than those with physical health problems to end up seeing out-of-network physicians. Costs were also higher for those with behavioral health issues. On average, individuals with mental health conditions ended up paying $341 more than those with diabetes. Those with drug use disorders ended up paying $1,242 more than those with diabetes.
People with behavioral health problems have a heavy burden to bear in navigating the complex system of accessing care. Innovations are needed throughout the stream of the system, particularly upstream where prevention could save millions in downstream traumatic drags such as incarceration and homelessness. However, much like the response to a sinking ship, many are working feverishly to scoop out water–rather than to have the forethought and action to design a more effective boat in the first place.
Did you know that people who are homeless but spend at least seven days in a prison, or hospital bed- are considered “housed” and on the intake assessments for receiving services, these people will not score as poorly on the vulnerability index as a person who slept every night on the streets.
Policy makers and industry leaders need to take a holistic account of the state of the mental health system including the places where people live, work and include the important sectors like the criminal justice system. In looking at the system as a whole, there are clear points where drains are evident calling for innovation. Synergies are needed at the points in the system that intersect. For instance, noting that a bulk of crisis care 911 calls are received from the local Greyhound bus station– and end with an expensive and largely ineffective trip to a local hospital.
An innovation leader might look at that node in the system and begin to ponder how to obtain better outcomes. Asking, what people and industries could coordinate to formulate a better way here? Often times- we look to sophisticated technological advances as the way to innovation. However, innovation that is meaningful, and sustainable, is doing something new in a manner that simply–work better.
Using the example of the Greyhound Bus Station– innovation would be to form a pilot program where basic services can be found at that geolocation. Perhaps articulate an agreement with a mental health ACT team where they make rounds at the Greyhound station twice a day , or have some method of communicating with people there in need. This is a perspective that can be gain through examining the system as a whole, and creating hospital-community partnerships is the way to creating sustainable innovation.
SOURCE: bit.ly/34HCUE3 JAMA Network Open, online November 6, 2019.
Maricopa's Mental Health Freedom Trails 