The Basics

  • “A Broken System When It’s Needed Most” – as NHMH has advocated since its creation 13 years ago, it is an urgent need in our country to make effective mental health care available where the majority of behavioral health patients go, i.e. medical settings such as primary care. COVID-19’s after-math is highly likely to make this reality widely understood. The solution: The federal and state governments (through Medicare and Medicaid), and private insurance companies, must pay for and reward clinicians who integrate evidence-based behavioral health services into their primary care practices. Rather than costing our healthcare system more, it will mean substantial cost savings, given fact it will lower medical expenditure costs. This is the future — behavioral health services integrated into medical settings — that NHMH has long recognized and worked for and the C-19 pandemic has shown is critically needed.

  • There are proven successful behavioral health treatments possible in primary care –such as collaborative care (psychiatrist consults to medical doctor and is part of care team along with a care manager), embedded behavioral professionals (psychologist, social worker with office down hall from medical doctor), behavioral screening, short brief behavioral interventions …however, the vast majority of medical practices are not providing them to patients due to time, financial and other practice constraints;

  • Two-thirds of primary care doctors say they have significant problems getting patients with mental disorders into mental health care; this is a big frustration for primary care doctors;

  • A disconnect exists in our health system where behavioral services are carved out, handled separately from rest of the medical system forcing patients to navigate two systems for care;

  • The commercial health insurance industry needs to incentivize integrated models such as collaborative care, not discourage these integrated systems as behavioral carve-outs do;

  • Now behavioral care functions completely independently of medical healthcare, with different care delivery systems and different provider networks, with little or no communication between the two;

  • 70% of patients with behavioral issues go only to the medical setting; and only half of primary care patients referred by their medical doctors to the behavioral health sector, go, and among those who do the average number of visits is two;

  • Medical doctors have not been trained to treat behavioral health issues;

  • 95% of behavioral professionals (psychiatrists, psychologists) work only in the behavioral setting where only 25% of behavioral patients are!

  • Among most costly patients in our health vstr system are those with co-existing chronic medical issues and behavioral issues, they represent 15% of patients yet account for 60% of total U.S. healthcare costs; treating them successfully and early is a big cost savings opportunity.

  • Behavioral health should be like every other medical sub-specialty (e.g. oncology, pediatrics, obstetrics, etc) with behavioral providers part of medical networks, care delivered together and health plan benefits encompassing both treatment for physical and behavioral in one plan.

  • A specialty behavioral health sector will still be needed for patients with serious mental illness like schizophrenia, major bipolar disorder, or major depressive disorder, but they are only 10% of all behavioral patients.


Big Win for Patients' Accessing Mental Health Treatment in Primary Care ... See MoreSee Less
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Big Win for Patients Getting Quality Mental Health Care in Medical Clinics ... See MoreSee Less
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