Addressing the Deficiency in Behavioral Health Services in the United States Health Care System
Introduction:
Access to adequate behavioral health (including emotional, psychological and substance use disorders) services remains a significant concern in the United States. This deficiency is attributable to various factors, including access to providers, cost of care, education on benefits, differences in provider guidelines etc., some of which are resolvable. The consequences of underutilizing behavioral health services range from diminished quality of life to tragic outcomes, impacting not only individuals but also their families, friends, employers, and the broader community.
Government Initiatives
State and federal regulators have initiated measures to meet the behavioral health needs of individuals, with a primary focus on achieving behavioral health parity. At the state level, regulators are attempting to monitor compliance with behavioral health parity regulations. Simultaneously, at the federal level, there is an ongoing effort to revamp and strengthen these regulations.
Provider Shortages
One significant obstacle to improving behavioral health access is the pervasive shortage of behavioral health providers. This situation is even worse in the rural areas where provider shortages are the highest. Telehealth is being used to ease the situation in many areas. Another potential solution to increase availability is allowing non-certified providers (sometimes called paraprofessionals or dependent practitioners) to practice under the supervision of certified practitioners. Even emergency medical service providers are being used to provide services in these rural areas in what is known as community paramedicine. However, this approach faces obstacles, as certain insurers offer lower reimbursement or outright refuse to reimburse for services provided by non-certified individuals. Additionally, insurance company fee schedules often offer inadequate compensation, discouraging providers from entering into contracts with insurers.
The Grim Consequences
The repercussions of the underutilization of behavioral health care services is evident in the alarming rates of teenage suicides and the prevalence of gun-related deaths. These distressing statistics underscore the urgent need for comprehensive reforms in behavioral health care access and delivery.