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Let's bring behavioral, mental health into the mainstream


Most of last week's headlines focused on the Affordable Care Act. Rightfully so, too--the open enrollment period ended, and then it didn't, and then it was re-opened for those facing tax penalties, while the debate about King v. Burwell raged as the hearing date nears.

Like a scorned public figure seeking retribution, though, I'm not here to talk about the past. Instead, I look to the future. This blend of crystal-ball gazing and wishful thinking stems from two headlines I saw last week. Both were short stories on FierceHealthPayer--but I'd like to think, in time, the topic will warrant more ink.

The first concerns Health Care Service Corp., which recently concluded a behavioral health pilot program that reduced stress and increased "mindfulness" in 200 employees at three HCSC locations. All it took was seven- to 13-minute Web-based audio exercises once a day for eight weeks for employees to feel better and more focused.

The second comes from Ohio, which aims to join a growing number of states enrolling prisoners in Medicaid, according to USA Today. The endeavor comes with two ambitious goals: Save money and cut down on repeat offenders by ensuring that inmates have access to mental health and substance abuse services when they are released from prison.

For too long, behavioral health and mental health, along with anything generally described as therapy or alternative medicine, have sat at the periphery of our health system. As but one example, access to psychiatric care is severely limited in most major cities--and when such care is available, insurers face accusations of denying mental health claims. In the rush to see patients, treat them, release them, file claims, get paid, pass "Go" and collect the proverbial $200, it seems the healthcare industry all too often fails to address the numerous and complex unseen factors that bring people to the doctor in the first place.

The two stories above suggest that we're finally challenging this point of view. In a way, it's common sense. Employees who take time to clear their minds at the beginning of the work day find it easier to focus? Prisoners--and others, for that matter--who receive affordable access to healthcare may not slip through society's cracks and get in trouble again? Who'd a thunk?

To make this happen, of course, it takes a village. Payers must be willing to cover these services. Employers must be willing to let employees seek these services without fear of retaliation. Providers must be willing to, well, provide these services, and in a safe, comfortable, judgment-free environment at that.

More importantly, everyone must be willing to see the inherent value in these long-stigmatized and -ostracized services. Just as wellness programs are helping to challenge the notion that the best workers remain tethered to their desk all day long, pausing only to wolf down processed food for "lunch," we must also push back at those who think that meditation, yoga and openly discussing one's problems are hippy-dippy stuff, and that mental health and substance abuse programs are reserved for the downtrodden or those who otherwise fail to "fix" their problems on their own.

It won't be easy. Healthcare is already expensive; paying for even more services--especially those without a demonstrative, short-term ROI--makes little sense to many both within and outside the industry. What's more, many behavioral, mental and alternative health programs don't have the same proven success rate as more "traditional" treatment methods. (Then again, we all thought flu shots worked pretty well.)

That said, it's worth a shot. If the work at HCSC and in the Ohio Department of Rehabilitation and Correction proves to save money and improve overall health, then payers and their clients would be wise to give a second chance to services they may have otherwise dismissed. Brian (@Brian_Eastwood and @HealthPayer)

Related Articles:
HCSC behavioral health program helps reduce stress
'60 Minutes' accuses insurers of denying mental health claims
Access to psychiatric care severely limited in major cities