Ron Manderscheid, Ph.D.
Executive Director, NACBHDD
Earlier this week, I outlined seven ways that the Patient Protection and Affordable Care Act (ACA) helps get individuals with mental health conditions in the door to access mental health services.
Today, I’ll examine the ways in which the ACA helps individuals retain access and benefit from individualized, consumer-centered care and services.
Once in the Door
Once in the door, the ACA helps assure that behavioral health services begin with prevention and early intervention, are evidence-based, are integrated with physical health care and other needed services and supports, and engage the consumer as a partner in care.
- The ACA moves upstream, providing access as never before to prevention and health promotion services that can mitigate behavioral problems early, reduce symptoms, or keep them from happening altogether. More than 71 million Americans can now get free preventive services including screenings for alcohol abuse and depression. ACA funds have been used to help promote the adoption and implementation of a range of best practices in health promotion, illness prevention, and early intervention through grants and other mechanisms.
- ACA funding is helping to advance a whole-health approach to individualized care. The importance of this cannot be overestimated. People with mental health conditions are at heightened risk for other chronic health problems, from hypertension to heart disease, and from diabetes to substance use or misuse. However, even when getting mental health care, most get little or no care for co-occurring physical problems. Treatment for co-occurring substance use and mental health conditions generally doesn’t happen either. When it does, the services are often sequential and not coordinated, reducing the benefits of treatment. Today, however, the ACA is helping to advance programs that will promote more integrated care that focuses on the entire person, not on a diagnosis or named health problem. For example, the ACA authorized creation of Medicaid health homes. These are grounded in a team-based clinical approach that includes the consumer, their providers, and their family members, when appropriate. Services span the gamut of health care needs and supports, providing centralized care management and support to individuals as they work toward self-management goals. An increasing number of states have embraced these models to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions, such as PTSD and depression. Further, SAMHSA and its sister agency, the Health Resources and Services Administration, have been working to better coordinate primary and behavioral health care within and across settings by identifying and assessing best practices in integrated care. And they’re collaborating to build a workforce of clinicians and peer supports who understand the value of a consumer-centered approach to integrated care of the whole person.
In my next post, I’ll talk about other opportunities for and challenges to improving access to care and quality for people with mental health and substance use problems, including the urgent need to increase the field’s resource capacity to meet the new demand for care and supports as the ACA moves forward.
Would integrated care or early intervention have helped you or your loved ones experiencing mental health conditions? Comment below and let us know!