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HHS Roadmap Takes Broad Approach to Behavioral Health Integration
Against the backdrop of a national behavioral healthcare landscape in which 52.9 million adults have been impacted by mental illness, 37.9 million by substance use disorders (SUD), and 17 million affected by both, the US Department of Health and Human Services (HHS) has rolled out a roadmap for integrating behavioral health into larger healthcare systems in support of the Biden administration’s Strategy to Address Our National Mental Health Crisis.
“From Wilmington, Delaware, to Seattle, Washington, and cities and towns in between, I have heard directly from Americans and their providers about our nation’s behavioral healthcare challenges—including the pervasive and persistent disparities in access that exist across the country,” HHS Secretary Xavier Becerra said in a news release. “In order to ensure equity in access to affordable, high-quality, culturally appropriate care for mental health and substance use, we must fully integrate behavioral health into the larger health care system and other systems. This roadmap provides a path for getting there.”
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In the document, which was published this month, HHS categorized integrated care as “critical to transforming care for individuals with [mental health and substance use disorders]” and “an HHS strategic priority.” While integration frequently is defined as including behavioral health in primary care settings, for the purposes of its strategic rollout, HHS is also looking at including physical healthcare into behavioral settings and behavioral health into other specialty areas of care and other settings.
The roadmap identifies 8 key challenges to behavioral health integration that have been used as guideposts for HHS policy development:
- Structural support for siloed care
- Stigma and mistrust
- Limited technology adoption
- Inconsistent use of data and evidence
- Insufficient investment in promotion and prevention
- Insurance and financing limitations
- Workforce challenges
- Inequitable engagement of underserved populations
Meanwhile, the Biden administration’s Strategy to Address Our National Mental Health Crisis, which was unveiled in March, has 3 pillars on which HHS is basing its efforts:
Strengthen system capacity: HHS is focusing on initiatives that develop a diverse workforce that is prepared to practice in integrated settings and invest in integrated care infrastructure. This includes not only growing the specialty behavioral health workforce but also healthcare, social service, and early childhood care providers who are trained to recognize and address behavioral health conditions.
Connect Americans to care: HHS said it will look to leverage health financing arrangements, “including efforts to fully realize the potential of parity.” The department has identified insurance and other financing limitations among the most commonly identified barriers to behavioral care. “The idiosyncrasies of each financing system require that solutions be tailored to specific programs,” the department wrote. “To overcome this challenge, the department has identified opportunities to make behavioral health services more affordable for beneficiaries of Medicare, Medicaid, the State Children’s Health Insurance Program (CHIP), and any financing arrangement subject to the Mental Health Parity and Addiction Equity Act.”
Support Americans by creating health environments: HHS plans to advance the final pillar of the Biden administration’s strategy through investments in behavioral health promotion, upstream prevention, and recovery. The department said it “has identified opportunities to align structural supports and financing to integrate promotion and prevention programs in community-based settings, from early childhood to young adulthood, inclusive of schools.”
“The HHS Roadmap represents the department’s reinvigorated commitment to using every lever available to us to achieve the president’s vision for transforming the US behavioral health system, including collaboration with other departments, Congress, states and localities, and non-governmental stakeholders,” HHS concluded.
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