Envisioning Enticing Eventualities about Future US Behavioral Health and Healthcare: The 2014 ACMHA Summit

Futurists examine current developments and extend current trends to construct future scenarios and imagine future consequences. At the ACMHA: The College for Behavioral Health Leadership Annual Summit in Santa Fe, New Mexico, on March 26-28, all participants became futurists, and all were treated to a preview of enticing possibilities about future behavioral health and healthcare in the United States. Such an exceptional opportunity to think constructively about the future occurs only very infrequently.

Unlike any of its recent predecessors, this year’s Summit actually consisted of six mini-Symposia designed to consider different key aspects of the future. Topics reflected the major current concerns of behavioral healthcare: service integration and behavioral health policy, innovative leadership and self-directed care, and future partnerships and business models. Symposia discussions were shared periodically throughout the Summit to promote cross-awareness and thinking.

The Summit began with an orienting plenary session on The Future of Health Care: Entering the Shift Age, led by David Houle, noted author and futurist. Midcourse, participants also were treated to a presentation on Multisector Leadership Now and in the Future, led by Alonford J. Robinson, Jr., the CEO of Symphonic Strategies. David Houle offered a tantalizing picture of the future. Driven by the digital and mobile revolution, we are shifting to a global society. Healthcare will be swept along by this shift. Alonford Robinson provided leadership and management strategies that will help us cope with our changed ecology.

What are some of the likely future eventualities that were discussed?

As the Affordable Care Act moves us quickly into the future, we will be required to adapt to a new health home service delivery model rooted in integrated care, with team-based services and fully integrated funding. This is a radically different scenario than our lifetime of experience in a separated behavioral healthcare system.  We must develop strategies to help behavioral healthcare to fare well in this new world. Future policy may either aid or hinder this adaptation. To be effective, such policy must help behavioral healthcare to assume a similar relationship to primary care as that already enjoyed by other specialty health fields. Key considerations are the policy steps necessary to effect this transition.

Innovative behavioral health leadership will be necessary in the future for several key reasons. These include promoting successful adaptation to integrated care, facilitating the transition of the field from one rooted in clinical practice to one also rooted in public health practice, and successfully engaging a whole new generation of providers who will be trained with new expectations during the ACA era. Dramatic innovation also will occur in how people approach their own health and wellbeing, and the role they will play in their own healthcare. Unlike the past, in which people were passive recipients of health care, tomorrow’s people will be health-oriented, self-directed participants in every phase of care, who will share in decision-making and take a proactive role in self-care and wellbeing. Each of these developments will dictate dramatic changes in the critical facilitative role of peer support services.

Scenarios of the type described above will lead to new management models. Raw competition will be replaced by careful partnerships, with the organizational realization that a broader array of skills is essential for successful adaptation. Such partnerships are likely to extend well beyond behavioral health and health care organizations to encompass public health and public welfare entities, as well as to upstream organizations engaged in community development. The advent of health homes and new partnerships also will dictate new business models rooted in case and capitation rates.

One participant summed it up very well: “We need to become a behavioral health specialty linked to the broader field of health, just like everyone else.”

Why do we all desire to become futurists? By carefully envisioning the potential future, we can become better prepared now for both the opportunities and challenges that are likely to arise. In fact, by taking action now, we actually may be able to change less desirable aspects of the likely future. By becoming futurists, we also can reduce our own fear of the unknown and begin to reconcile our own expectations with the impinging future. In this era of very rapid and dramatic change, all of us in behavioral healthcare do need to prepare for a changed future, and all of us do need to reduce our fear of the unknown.

A major historic highlight of the 2014 Summit was a full-day pre-conference hosted by the ACMHA Peer Leader Interest Group. More than 40 peer leaders from across the US participated in this landmark event sponsored by Optum Health Behavioral Solutions. The group gathered together to discuss how the ecology of peer services is changing and what steps will be needed going forward. Clearly, as we move rapidly toward integrated care, new strategies and business models will be needed to transform peer services successfully. This was the first time in ACMHA’s four-decade history that peer leaders played such a prominent role in the Annual Summit. 

Our hats are off to ACMHA: The College for Behavioral Health Leadership and to Jeanette Harrison, the Chairperson for the 2014 Summit. This Santa Fe Summit has done a wonderful job in preparing us to confront a future that begins today.