According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are nearly 48 million adults aged 18 or over in the US living with a mental illness, 11.4 million of which are considered a serious mental illness. Yet just 43.3% receive the care they need. And the majority of care that is provided is done so through homeless shelters, hospital emergency rooms, and penal institutions—the latter serving as the largest in-patient psychiatric facilities in the US.

Now enter the COVID-19 pandemic, which has greatly heightened all aspects of mental illness, including anxiety, depression, substance abuse, suicide, and post-traumatic stress disorder (PTSD). Today, 64% of people surveyed say COVID-19 has negatively impacted their mental health and calls into one federal emergency hotline increased 1,000% in April alone. Research based on macroeconomic indicators predicts suicides from the pandemic could increase by more than 8,164 cases between 2020 and 2021. “The anxiety of the virus with the economic shock, along with the physical distancing, is an unprecedented assault on mental health.” Another study of more than 700 COVID-19 patients found that 96% were suffering from post-traumatic stress, which some researchers predict could become its own health crisis. Substance abuse has increased as well; deaths by suspected drug overdose increased by 42% in May.

INCREASE IN REPORTED MENTAL HEALTH SYMPTOMS IN ADULTS 18 OR OLDER

The pandemic’s impact on mental health, according to some experts, may cause a new healthcare crisis—one that we are nowhere near ready to handle.

Meeting the crisis head-on

More forward-thinking community mental health organizations across the country have already chosen to take a proactive approach to reducing the long-existing barriers to optimal behavioral health (BH) care by investing in a process to become a Certified Community Behavioral Health Clinic. Established by the Excellence in Mental Health Act of 2014, CCBHCs were designed to “increase Americans’ access to community mental health and substance use treatment services via CCBHCs while improving Medicaid reimbursement for these services.”

CCBHC grants offer federal funds and state matching funds to provide states an opportunity to: improve the behavioral health of their population through community-based mental and substance use disorder services; integrate physical health care with behavioral health; incorporate evidence-based practices; and expand access to high quality care.

A call to action

In April, SAMHSA announced the extension of the CCBHC demonstration program, along with a $50 million increase in Expansion Grants. While this is great news for now, it will fall short of creating long-term, sustainable improvements in the BH industry unless more states and community mental health providers get on board with the transformative nature of thie effort. Using the grants to invest in BH data analytics and technology is one of the most impactful strategies that can return the most significant, lasting improvements. Using these new technologies helps organizations capture the data needed to identify where to focus resources for the greatest impact on patients and costs. CCBHC funding also provides organizations the ability to expand the scope of their substance use disorder services. This might include adding additional staff, training existing staff, adding Medication-Assisted Treatment (MAT), or implementing the latest substance use screening protocols.

But grants require significant commitment. Depending on location, states must match 20% of federal funds in order for organizations to receive the remaining 80% of elgibile funds from the federal government. As they struggle to regain financial stability in the midst of the pandemic, the ability to justify this commitment may be in jeopardy without demonstrated proof that the investment delivers results. To do so, they will need to capture, track and analyze data. Owl Insights, a leading provider of technology that supports evidence-based practice for BH, can help by giving practices the data needed to improve treatment effectiveness and efficiency through measurement based care (MBC). Research shows the superiority of treatment with MBC over usual standard care (USC). A recent article published by Current Psychiatry states, “MBC is more effective than USC both in achieving response and remission, and reducing the time to response and remission. The article lays out the three main requirements for MBC as “useful measurements, integration with the EHR, and health information technology.” With Owl Insights, BH providers have all three.

With the proper technology infrastructure and funding through CCBHC grants, Community Mental Health Centers have the insight needed to address the source of high-need, high-cost patients by identifying and better managing the most at-risk populations. Knowing who they are and what they need, as well as the impact of recommended treatment, provides the tools necessary to address patients that need it most.

A physician leader in the Pacific Northwest, Dr. Jeffrey Eisen, MD recognizes the need for technology infrastructure in CMHC organizations as an effective method to lower costs and improve care quality in upstream health systems. “We were looking for new ways to serve our patient population and to do so more cost-effectively,” shared Eisen, chief medical and health integration officer at Cascadia Behavioral Healthcare. “Our goal was to capture and translate analysis into real-world improvements that align with the quadruple aim.” This means improving health outcomes and health equity, reducing cost of care, increasing patient satisfaction, and ensuring provider well-being.

The challenge was how to capture, track, and analyze the data to identify patients with the greatest needs and who generate the highest costs. “Without that ability, we end up treating all patients the same,” Eisen said. “And that type of one-size-fits-all approach is what got us here in the first place.” Applying the same type of population health approach and personalized care management to mental health as does medical care delivers significant impact and supports scaling existing resources.

Owl Insights gives behavioral health providers the ability to triage patients and identify the right level of support. If care is no longer working, Owl’s analytics let providers know that they must pivot care. The Owl platform then aggregates the data, which fuels more effective decision support and enhanced patient engagement. With greater insight into each patient, providers no longer need to rely on a one-size-fits-all approach to care. Owl provides automated measure scheduling and actionable reporting through its library of more than 100 clinically validated measures, including a bundle focused on COVID-19. Providers get the information and tools they need to support their CCBHC programs—driving improved outcomes and significantly lower costs—both now and post-pandemic.

1. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
2. https://www.thenationalcouncil.org/wp-content/uploads/2017/11/National-CCBHC-survey-write-up-FINAL-11-28-17.pdf?daf=375ateTbd56
3. https://www.washingtonpost.com/health/coronavirus-is-harming-the-mental-health-of-tens-of-millions-of-people-in-us-new-poll-finds/2020/04/02/565e6744-74ee-11ea-85cb-8670579b863d_story.html
4. https://www.washingtonpost.com/health/coronavirus-is-harming-the-mental-health-of-tens-of-millions-of-people-in-us-new-poll-finds/2020/04/02/565e6744-74ee-11ea-85cb-8670579b863d_story.html
5. https://www.psypost.org/2020/07/suicide-rate-projected-to-increase-as-unemployment-jumps-from-coronavirus-outbreak-57210
6. ibid.
7. https://www.webmd.com/lung/news/20200507/ptsd-may-plague-many-covid-19-survivors#1
8. https://www.washingtonpost.com/health/2020/07/01/coronavirus-drug-overdose/
9. https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm
10. https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/
11. https://www.thenationalcouncil.org/topics/excellence-in-mental-health-act/
12. https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria.pdf
13. https://www.hhs.gov/about/news/2020/04/27/samhsa-awards-grants-expanding-community-based-behavioral-health-services-strengthens-covid-19.html
14. https://pubmed.ncbi.nlm.nih.gov/26315978/
15. https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/CP01806006.PDF