The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to weigh in on their approaches to the sector’s thorny issues.
Manny Arisso, chief network officer and employer market president at Carelon Behavioral Health (part of Elevance Health), and Hannah Wesolowski, chief advocacy officer at the National Alliance on Mental Illness, discuss ongoing barriers to access and their reasons for optimism regarding behavioral healthcare.
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What trends are you seeing regarding the demand for mental health services, compared with the rise in care needs at the height of the COVID-19 pandemic?
Arisso: As you think about pre-pandemic, post-pandemic and where we are today, even further removed from the lockdowns and isolation, and the impact those had on overall well-being, certain things continue to be challenges. Those include substance use disorder and the opioid epidemic in this country. And they also include suicide rates, specifically among our youth.
Wesolowski: The need is still elevated. Before the pandemic, about 1 in 10 adults were experiencing challenges in terms of anxiety and depression. During the pandemic, it hit a high of over 4 adults in 10. Now it’s been holding steady around 3 in 10, according to the [Centers for Disease Control and Prevention’s] Household Pulse Survey. But we continue to struggle with access to care.
Does staffing continue to be a challenge when it comes to the amount of care and services needed?
Arisso: Broadly in the industry, there’s been an expansion of well-being services. Regarding recruiting professional staff, I would say it’s better than it was six months ago, nine months ago. But it’s not without challenges. And there’s also an opportunity, going live in 2024, regarding the multistate Counseling Compact, which will allow for therapists licensed in one market to practice in other markets.
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Wesolowski: The last number I saw from the Health Resources and Services Administration was about 160 million Americans—nearly half the population—live in a mental-health-provider shortage area. So there simply aren’t enough professionals. What we have seen that’s been refreshing is telehealth. It continues to play an outsized role in accessing mental health services compared with other types of healthcare.
What are you and your colleagues most optimistic about?
Arisso: There’s been a lot of attention and focus on behavioral health, more so than at any other time. With that focus, investment and other opportunities, there’s been an expansion of resources. And we’ve seen a lot of innovation in this space. So I think the bright line in all of this, in part accelerated by COVID, is that there has been a significant de-stigmatization of mental health.
Wesolowski: The pandemic opened up the conversation about mental health, because no one was unimpacted by challenges with our mental health during that time. So I think there’s more empathy. There’s also more awareness. I think that’s really broken down a lot of the stigma around having a mental health condition or symptoms of a condition. And there’s also more openness by policymakers to find solutions.
