Public Health

Boosting access to mental health care during pandemic and beyond

Tanya Albert Henry , Contributing News Writer

When the AMA convened a value-based care advisory group a couple of years ago, physicians, employers and health plans had a clear message: The approach could only succeed when medicine addressed patients’ behavioral health needs adequately and universally.

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It was a wake-up call, leading the AMA to establish the Behavioral Health Integration (BHI) Collaborative with seven other physician associations to help overcome obstacles to integrating behavioral and mental health care into primary care practices, Kathy Blake, MD, MPH, the AMA’s vice president of health care quality explained during a recent episode of the “AMA COVID-19 Update.”

The goal is for the patient to receive mental health care within the primary care office, whether from a psychiatrist, other mental health professional, or a combination using a team-based care approach. The need to expand services to settings that patients can more easily access and are familiar with has only become more imperative as the nation’s mental health suffers during the pandemic.

“Prior to COVID, a large portion of Americans were affected by mental health and substance-use disorders. And they’re really still not receiving the care they need and now with COVID, it’s really only exacerbated those problems... There’s stress, there’s isolation and trauma from what is going on today,” said Kristin Kroeger, chief of policy programs and partnerships at the American Psychiatric Association (APA).

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“We’re so happy that the AMA has pulled all of the organizations together to do this because we need to really look to ensure early intervention and prevention of these illnesses in primary care,” Kroeger said.

Learn more with the AMA about behavioral health integration in physician practices.

Dr. Blake described the BHI Collaborative as an “all-in, multispecialty team-based effort.” The collaborative brings together groups with different perspectives, she said during the online discussion.

The American Academy of Family Physicians (AAFP), the APA, the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics are focused on the impact of COVID-19 on children, adolescents and their parents.

The American College of Obstetrics and Gynecology is particularly interested in maternal health, especially the risk of postpartum depression as new moms are experiencing more isolation than before the pandemic. The American College of Physicians and American Osteopathic Association also bring their unique viewpoints to the group.

“We don’t want to reinvent the wheel and what we realized is that there are resources and experiences that we can start to compile to be able to deliver this care holistically,” Dr. Blake said.

Behavioral health and physical health are tied together.

Consequently, “if behavioral health needs are not met, then physical health needs are even more difficult to meet,” explained Amy Mullins, MD, the AAFP’s medical director of quality and science. “So, it’s really hard to control a patient’s diabetes or high blood pressure if we’re not addressing the behavioral health needs first. That is why this conversation is so important.”

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Dr. Mullins said the increase in telehealth use may have been one of the silver linings this year because it allowed practices to experiment with delivering behavioral and mental health services. In turn, that may kickstart more practices to try to integrate this care.

To help physicians offer mental and behavioral health services their practices, the BHI Collaborative has put together the “Overcoming Obstacles” webinar series. By year’s end, the BHI Collaborative will release a playbook that includes a wealth of information that various medical specialties have already compiled to help smaller and medium-sized practices integrate behavioral health.

The Collaborative also has committed to developing a user group in 2021 of practices implementing this approach. The practices will provide feedback on what works and what doesn’t. That, Dr. Blake said, will help the collaborative expand and improve the resources provided to physicians and their practices.