As COVID-19 and nationwide protests bring demand for behavioral health services even higher, the nation's scarcity of providers likely will become more pronounced.
And even though some providers have been working to integrate behavioral and medical health for a few years, there are a host of organizational, cultural and financial burdens to overcome, many of which are highlighted in a RAND Corp. study published June 1 in the Annals of Internal Medicine.
In a survey of 30 physician practices that have integrated behavioral health, either through colocation or collaborative care, respondents said it's hard to merge billing and electronic medical records and to find a payment model that works. They also said it's difficult to calculate the return on investment of integration, which can make it challenging to garner continued support from parent organizations.
Some challenges can be addressed by interprofessional training and collaboration, as well as through improvements to EMRs and clarification of privacy regulations, the study found.
"We found that behavioral health integration is possible in a wide variety of medical practices, not just in primary care," Dr. Peggy Chen, co-author of the study and a physician researcher at RAND, said in a prepared statement. "The key factor in the success of behavioral health integration was adaptation to each practice's needs and resources."
The leaders in the practices surveyed said integration helped them better provide high-quality care to patients and meet the needs of patients.
"The COVID-19 pandemic has exposed and magnified the flaws in our mental health system and the true burden of mental illness in our country," said Dr. Patrice Harris, president of the American Medical Association. "Behavioral health care integration can help save lives and is a proven model that has many advantages over a more divided one."
Dr. Ken Duckworth, chief medical officer of the National Alliance on Mental Illness, said there's a long history of mental health, especially psychiatry, being treated separately from physical health. And practitioners in both worlds now treat patients differently, as a result.
"Some of these problems are big and hard," Duckworth said. "The culture between mental health and primary care is a different culture."
But finding ways to make behavioral health more accessible are needed, as the stigma associated with mental health lessens and demand for services grows, Duckworth said. And that need is even greater now as Americans are confronting the pandemic, stress, isolation, traumatization and racial discrimation, he said.
"Because demand has increased, we haven't figured out an adequate way to increase supply," Duckworth said.