NO HEALTH
WITHOUT
MENTAL HEALTH

Changing the U.S. healthcare system to make mental health services available as a routine, normal part of a patient’s medical encounters.

We work for a future where you can see a trained, qualified mental health professional for a consultation in the privacy of your primary care doctor’s office.

NHMH has done great work advocating for integrated care models which should help so many patients and families; I am inspired by its advocacy to improve the care of so many.

– Dr. Wayne J. Katon (Dec’d).

University of Washington, creator of the collaborative care/TEAMcare model of integrated care

Explains How Integrated Care Drives Quality

BEHAVIORAL HEALTH INTEGRATION
FROM THE PATIENT’S PERSPECTIVE


DEAR PATIENT, MENTAL HEALTH & ADDICTION CARE SERVICES ARE COMING TO YOUR PRIMARY CARE CLINIC:

WHAT TO EXPECT – BENEFITS YOU’LL GAIN – YOUR ROLE

 
Download entire blog here – BlogICFromPatientsPerspective

There is a new, and in some cases, improved, change coming to your primary care clinic soon:  receiving mental health and drug and alcohol care right in the same place and often on the same day.  Treating the whole person in one place, primary care, versus having to go to several sites for physical and mental health/substance use care.   Up to now, nearly all primary care patients with these problems were referred out to mental health professionals who may or may not have coordinated that behavioral care with your primary care doctor.  External referral for BH care may still happen for patients with serious mental illness.

What is new, and in some cases, improved, is that the majority of patients with mild or moderate BH problems may now receive care right in their primary care facility.  This will build on the trusted relationships patients already have with their medical doctor, and the comfortable primary care space with its private, confidential setting with the patient’s longtime health history in mind.  And for those clinics already incorporating mental health/substance care, the services will expand, allowing for better communications between medical and mental health professionals and more rigorous follow-ups on how patients are doing.

Step 1: The Big Picture

This new innovation of integrated care will apply only to primary care patients who have BOTH a medical and mental/substance problem.  If a primary care patient has only medical issues, this innovation will not apply.  Even so, it is important to be aware of as you may have family members for whom this integrated care service may be relevant.  Primary care patient populations across the country differ in many ways so data shows integrated care services will likely be relevant to 20%-40% of a clinic’s patients.

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WHAT NEXT?

Where We Are: Ultimately integrating BH services into general medical care will not be sustainable in a fee-for-service world where physicians are paid for volume not value. Sustainable integrated care will only occur with a value-based (VB) payment system that provides flexibility and shared accountability and incentivizes high quality care in a meaningful manner.

Need to Develop Quality Measures: A VB payment system necessarily entails establishing a set of quality measures – structural, process, and outcome – which demonstrate value, efficiency and outcomes results, and hence allow payers, government and commercial insurers, to pay those practices rewarding them for high-quality care delivered.

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A CALL TO ALL BEHAVIORAL HEALTH INTEGRATION STAKEHOLDERS:   PUT PATIENTS F-I-R-S-T!

To make behavioral integration into medical settings a reality NHMH calls upon all stakeholders to Put Patients First! and relinquish narrow vested interests tied to the status quo.  Now is a time for innovation and for putting the whole health needs of American citizens, mental and physical, first and work together to get that done.  Now is the time for implementing effective, proven integrated medical-behavioral care that is team-based, measurement-based and value-based.

In this first installment of our new NHMH 2021 Mission Statement we discuss:

* Issue overview
* The human toll (true story from frontlines)
* How siloed behavioral-medical care delivery and payment came to be
* Healthcare system changes required now
* Cost to fix
* NHMH specific legislative and regulatory “Asks”

Mission/Policy Statement

NHMH

Is a nonprofit advocacy organization working at the federal and state policy level to make effective behavioral…

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A RECOGNIZED LEADER

In advocacy for medical-behavioral integrated care which means having both your physical…

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BRINGS VALUE

In improved physical and behavioral health outcomes and lowered total  healthcare costs…

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WE GET RESULTS THAT MATTER TO PATIENTS

2022:

  • Congressional Legislation Introduced.

    In 2022 four legislative bills have been introduced in the U.S. Congress, House and Senate, on behavioral health integration. The bills would train primary care physicians to deliver integrated care; increase payment to primary care practices that offer integration services; make behavioral integration in primary care a core part of Medicare and Medicaid programs; and test innovations in how hospitals might provide integrated medical-behavioral care to inpatients. NHMH has provided inputs and recommendations on these bills to the House Energy & Commerce Committee, the Senate Finance Committee and the Senate Help, Education, Labor & Pensions (HELP) Committee and has worked with individual Congressional offices of both parties in support of these bipartisan bills.

  • Biden Administration Includes Integrated Medical-Behavioral Care in its Mental Health Strategy.

    Integrated care is now included in the Federal Government’s March 2, 2022 White House Mental Health Strategy for the first time. See p. 4, the Connect Americans to Care section, bullet #2. This prioritization of integrated care by the Administration is a meaningful, substantive development. While the funding the White House proposes must be enacted by Congress, the federal health department’s (HHS) testing of new payment models to reimburse primary care doctors for providing integrated care can now go ahead. Another significant building block in widespread implementation of whole person care.

2021:

  • New High-Level Bipartisan Call for Health Policy Change Enabling Behavioral Health Integration.

    On March 30, 2021 the highly respected independent Bipartisan Policy Center issued a detailed report urgently calling for integration of mental health into primary care. The Report led by a BPC Task Force comprised of experts and former Members of Congress from both parties, details specific policy actions that should be taken by Congress and relevant health agencies to make effective, evidence-based mental health services available in primary care across the country. NHMH has been engaged with the BPC since 2014 to advance BHI and believes this Report to be a major breakthrough to place BHI high on the health policy reform agenda.

    Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration | Bipartisan Policy Center

2020:

  • Congress Enacts New Law Effective 2020 Helping States to Enforce Compliance with 2008 Federal Parity Law

    The 2020 federal law provides States with badly needed new funding to allow them to carry out mental health parity enforcement and implementation required by the federal parity law passed in 2008. Parity = Access to mental health care. With that in mind, Congress passed the 2008 federal parity law to require a majority of health insurance plans, including those provided by private employers, to cover treatment for mental health conditions no more restrictively than treatment for physical conditions. Implementation of the 2008 federal law requirement by insurers has been slow. The 2020 law funds States to support their oversight of health plans’ compliance with parity requirements as long as States collect and review comparative analyses from insurers.

    MHLG Letter to Senators Murphy and Cassidy

  • Number of Nurse Practitioners Doubles Playing Key Role in Primary Care

    Between 2010-2017 the number of nurse practitioners (nurses with advanced training) grew by 109%, as compared with growth of RNs of 22% and physicians 9%. NPs play a vital role in team-based care such as the integrated medical-physical care in primary care. The significant growth of this key healthcare worker category reflects the increasing focus on improving primary care advocated by groups such as NHMH. Increased educational programs in nursing schools, part of NHMH’s advocacy focus, allows for graduation of more NPs to join primary care clinical care teams.

    nurse-practitioner-workforce-doubles-amid-primary-care-push

2019:

  • Congress Renews Patient-Centered Research Organization Working to Advance Behavioral Integration into Primary Care

    NHMH was one of a coalition of 200 organizations that successfully advocated for Congress to re-authorize the Patient-Centered Outcomes Research Institute (PCORI). With the signing of HR 1865 into law on December 20, 2019, PCORI was re-authorized by Congress to continue its research trials developing information for patients and providers on which treatment approaches work best for what conditions and for which patients, until September 29, 2029. Currently, NHMH is participating in several ongoing PCORI national and regional research studies, all comparing different approaches to integrating mental health treatment into primary care for their effects on patient outcomes, with the aim to make that information available to patients and their doctors.

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We Need Your Help!

NHMH is a national leader in patient advocacy for the integration of medical and behavioral healthcare services.  Why? Because we have kept this one single focus and mission since our establishment in 2007. We also have deep, decades-long understanding of behavioral health policy and practice, as we grew out of NAMI. NHMH receives no government, corporate, pharma or insurance industry money.  This allows us to be an independent voice for the patient and families, always putting their interests first.

In addition to receiving online donations via Paypal, debit or credit card, or by check, NHMH also accepts stock donations.  Please contact us for details.



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San Francisco's Fragmented Mental Health Services Are Literally Killing Its CitizensSan Francisco’s fragmented city services are harming – and killing – the most vulnerable,S.F. Chronicle, Michael Cabanatuan Sep. 27, 2022 “A small number of San Franciscans — almost all of them unhoused — are responsible for overly heavy use of both the city’s medical and legal systems — but the systems’ fragmented approach is failing, according to a new study. The study, from the nonpartisan California Policy Lab and the Benioff Homelessness and Housing Initiative at UCSF, shows that a small group of people are repeatedly cycling in and out of both the county’s health and criminal legal systems each year and represent a disproportionately high amount of utilization of these systems.The systems provide fragmented care that fails those who use it, the study’s authors said, and one finding backs that up: Nearly one in four of the people with heavy use of both systems in 2011 were dead by 2020, “reflecting how vulnerable these individuals are and how high the stakes are for improving the systems that support them,” said co-author Dr. Hemal Kanzaria, medical director at Zuckerberg San Francisco General Hospital and an associate professor of emergency medicine at UCSF.The study underscores what health care workers and public hospital officials told city leaders in July — that far too many people struggling with severe mental illness and addiction cycle through San Francisco’s overburdened emergency rooms, failing to get long-term help, and at a high cost to the city. For instance, just five people in the past five years accounted for 1,781 ambulance transports, possibly up to 2,000, at a cost of $4 million.The study’s authors called for a more coordinated approach, such as connecting people released from the emergency room or jail with housing and continued care. “Our research highlights the need for coordinated, evidence-based interventions to address these individuals’ complex needs, promote stable housing, and prevent poor health outcomes including untimely death,” said co-author Dr. Maria Raven, chief of emergency medicine at UCSF Medical Center and co-lead of the Benioff Homelessness and Housing Initiative program on adults with complex needs.The study looked at 10 years of data from 270,000 people who used the city’s acute medical care or legal systems between 2011 and 2020. It narrowed its focus to two groups of people who had interactions with both systems in the same year, one from 2011 and one from 2020, to investigate trends among frequent users of city services.The study is unusual, researchers say, because it links data from multiple agencies to see how people are using critical city services including mental and physical health care and housing over a several-year period.Among the study’s findings, according to the Policy Lab:• About 24% of the 2011 group continued their high use of both systems the following years but their use declined each of the following years. • Between 80% and 90% of the people in the 2011 and 2020 groups had substance use problems and many also had chronic mental and and physical health issues. • More than 90% of the individuals in both groups had been booked into jail for a felony and a misdemeanor. • The research team determined that many of the people in the 2020 group were in San Francisco in 2011 and had contact with both health and criminal legal systems in the prior 10 years. For example, 30% of the 2020 cohort was booked into jail in 2011.” Michael Cabanatuan is a San Francisco Chronicle staff writer, email: mcabanatuan@sfchronicle.com ... See MoreSee Less
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NHMH Salutes the Passing of American Scientist Dr. Paul Greengard, a Pioneer in Brain Research and Mental Health Treament. We owe Dr. Greengard a great debt for his incredible, break-through work, and his amazing life of service.

https://www.rockefeller.edu/news/25634-pioneering-neuroscientist-nobel-laureate-paul-greengard-dies-93/

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treatment of a behavioral health issue at your
primary care office… or didn’t…  (first names only)

OUR PARTNERS & COLLABORATORS

“If you have doubts about the efficacy of offering collaborative care in the primary care setting, just ask a primary care physician who has been exposed to this efficient consultative support, and ask patients who have seen both their physical and behavioral issues addressed in one place in a coordinated fashion and see what response you get!”

Dr. Mark Williams, Mayo Clinic

Read full interview with Dr. Mark Williams of the Mayo Clinic.

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