We Must Integrate Physical and Behavioral Health to Truly Advance Health in America

After three years of caring on the front lines during the COVID-19 pandemic, health care providers are confronting a landscape deeply altered by its effects, including the emergence of behavioral health care as an even greater challenge.

While behavioral health care has long been underfunded, underappreciated and stigmatized, the pandemic intensified the unmet need for services and heightened difficulties for individuals with behavioral health conditions in accessing care.

We know that behavioral health is linked to a patient’s physical health. We also know that both behavioral and physical health conditions are present in many hospitalized patients.

To address this growing challenge, hospitals and health systems around the country are creating new innovations around how behavioral health disorders are identified and treated.

For example:

• Yale New Haven Hospital in Connecticut remodeled its approach to behavioral health treatment by melding new care teams composed of psychiatrists, nurse practitioners, advanced practice registered nurses, clinical nurse specialists and psychiatric social workers — all collaborating to identify and address patients’ behavioral health needs early in their care journey. The result: reduced lengths of stay, fewer costs and staff anecdotally reporting a boost in their own job satisfaction.
• In southern Los Angeles, about 10,000 patients come to MLK Community Healthcare’s emergency department with behavioral health needs each year. MLK Community Healthcare implemented an innovative pilot program integrating medical and behavioral health care in the emergency and inpatient environment with long-term follow-up treatment in the outpatient environment. The pilot program was successful and is now a signature approach for effective behavioral health care.
• Baystate Franklin Medical Center, which serves a small rural community about 100 miles northwest of Boston, built a “bridge” to addiction services with a new mobile clinic that offers patients Opioid Use Disorder treatment where they are — be it a recovery center, library, home or the Salvation Army.

Behavioral health remains a top priority for the AHA as it cuts across each of the pillars in our 2022-2024 Strategic Plan. During Mental Health Awareness Month we’ve been spotlighting many efforts and resources on behavioral health as we lead efforts to:

• Increase hospitals and health systems’ integration of physical and behavioral health services in acute inpatient, emergency department and primary care.
• Further initiatives by hospitals and health systems, community partners, social service agencies and others to expand access to a continuum of behavioral health services in a region.
• Reduce stigma and deaths of despair, while addressing the unique stigmas of specific age groups, cultures and other demographics.
• Prevent suicide through behavioral health initiatives, awareness and intervention.

We also continue to push Congress for expanded resources to provide mental and behavioral health support services for patients and care providers. Among other priorities, we continue to advocate for:

• Eliminating Medicare’s 190-day lifetime limit for inpatient behavioral psychiatric admissions.
• Repealing the Medicaid Institutions for Mental Disease exclusion, which prohibits the use of federal Medicaid funds to cover inpatient mental health services for patients aged 21 to 64 in certain freestanding psychiatric facilities.
• Increasing targeted funding for facilities that provide pediatric mental health services and invest in the pediatric behavioral health workforce.

While Mental Health Awareness Month provides an excellent opportunity to spotlight many resources and examples of how hospitals and health systems are working with their communities to advance the health of individuals and families, we must keep up the momentum throughout the year.