Susan Weinstein, JD
Editor in Chief, Care for Your Mind
As you head out to pick up some items from the big retail store near you, your shopping list might include toothpaste, light bulbs, milk, and diapers. Can you imagine a therapy appointment being one of the items?
This week, Boston-based Beacon Health Options announced plans to open Beacon Care Services mental health clinics in retail stores, beginning with a Walmart store located in Carrollton, TX.
Throughout our five-plus years of publishing Care for Your Mind, access to affordable, high-quality mental health care has been our ongoing concern. Will the Beacon Care Services approach increase access to mental health care? It just might.
The most common barriers to care include availability and convenience of services, negative attitudes about mental health, and cost. How does the Beacon Care Services venture address these issues?
Making care available and convenient
Bringing mental health services to where people are makes a difference in their being willing to utilize them. One approach is integrated care, where at its best mental health services are available in the primary care practice. In What Does Integrated Care Actually Look Like?, the Mayo Clinic’s Angela Mattson wrote that “bringing behavioral healthcare into the primary care setting is the most effective, efficient, and sensitive way to care for people with mental healthcare needs.”
In Will integrated care provide you with better care?, Laura Galbreath explains, “Integration improves access to mental health and addictions treatment by making that care a routine part of a visit to primary care, whether at the lowest level of integration (improved communication among providers) or the highest (a merged practice that includes both medical and mental health services). Integration also improves the quality of recovery by addressing the physical health care needs of people with mental illnesses and addictions.”
If you need more convincing, Dr. David Katzelnick makes the case that integrated care improves treatment outcomes and whole health.
The Beacon Care Services approach doesn’t end the persistent “silo” model of providing mental health care separate and apart from physical healthcare. However, it does improve access to and convenience of therapy services. Most of us go to the store far more frequently than we visit our primary care providers.
Getting around negative attitudes
The social stigma of mental illness remains one of the primary impediments to people accessing mental health care. People with mental health concerns fear others’ (and their own) negative perceptions of mental illness and are more likely to exclaim, “I’m not crazy!” than to seek help.
Education about mental health and knowing a person with a mental health condition are significant factors in reducing stigma. Having mental health services in a store should help to normalize the idea of engaging in therapy and, by extension, the notion of getting care for depression, anxiety, and other mental health conditions. Perhaps Beacon Care Services can hang a few posters that promote mental healthiness, encourage help seeking, and raise awareness among family caregivers.
Paying for care
Affording mental health care can be daunting, especially when services are not covered by insurance or your insurance has a high deductible or you don’t have insurance. Many mental health providers – especially psychiatrists – do not participate in insurance plans. Kimberly Morrow offers ideas for getting the care you need in What to Do When You Can’t Afford Therapy.
We have yet to see the fee and payment structure for the in-store clinics. It’s unlikely that Beacon Care Services will offer the kind of “rollback”pricing Walmart is known for. Beacon Health Options has experience in dealing with insurance, so we hold out hope that services will be covered by insurance and, for those who don’t have insurance, the fees will be reasonable and, ideally, on a sliding scale.
Problems and promise
There are problems with mental health care delivery all over the U.S. and the world. Beacon Health Options has its share of issues, such as low reimbursement rates and shrinking networks of providers. We and they must continue to seek solutions that overcome the barriers to care and improve the quality of care through advocacy from the provider’s office to state capitols and the halls of Congress.
For areas where there are not a lot of mental health professionals or high levels of stigma, having services available at a regular destination makes sense. The care provided there must be high-quality, both evidence-based and appropriate for the person, including culturally-appropriate care. There must be a system of referrals for patients whose needs exceed the in-store capacity as well as the commitment to coordinate care with other providers. And the staffing levels should include plans for expansion in the same location because if this idea catches fire, it’s going to burn hot.
We look forward to seeing how the Beacon Care Services model plays out.
What do you think?
- Would you see a therapist at a retail store? What kind of store? What would be the benefits? What would be your concerns?
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Photo by: Staff Sgt. Stephanie Mancha Released | VIRIN: 111019-F-EI771-046.JPG