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Recognize Value of Online Debate Given Our Field’s Sprawling Accountability
Online articles can seem like a futile way to advocate change. Readers are unknown with varying levels of interest. Nonetheless, communicating in public forums has unseen power, often serving as a vehicle for good ideas to amass support. Where else should we turn to promote a better future for the behavioral healthcare field? It has no centralized processes for deciding its direction or making changes.
While the behavioral field has no one accountable for a strategy, many probably assume otherwise. There is a tendency to think someone is in charge—one’s employer, one’s trade or professional association, state or federal government? These organizations have influence, but a democratic society with free markets allows interest groups to fight it out. It can be messy with unexpected results.
Online articles can energize individuals and help circulate their vision of the future. This is especially important today. Critical changes are approaching for our field as we adjust to the healthcare industry’s monumental consolidation. Behavioral healthcare is a minor field in terms of its funding and power in the healthcare industry. This is a new position for our once-independent field.
The issue is more complicated than having no entity driving a central strategy. Which organizations are even focused on the future? Businesses focus on quarterly results and worry about the future from the prism of potential earnings. Associations mostly focus on improving conditions for members, while governmental policies and legislation generally have a limited scope.
The government may shape our future with laws, regulations, and funding, but businesses have wide latitude to pursue profitable paths. For example, access to behavioral care is abysmal, but not every solution is equally desirable. Businesses might favor profitable technologies over expanding licensed staff. Should you write your congressional representative if you don’t like that vision of the future?
Digital Media
Digital media offer a viable way to promote change when centralized planning does not exist. Such forums can provide an outlet for the views of those without money or power. A decentralized healthcare field needs to amplify voices and get as many people to own the future as possible. Digital media are a bullhorn, and messages can be projected out to leaders, experts, and the public at large.
We routinely make false assumptions about what business leaders, governmental policy wonks, and niche association groups are doing for our field. Their work does not address some of our biggest challenges because they are either driven by near-term goals, narrow interests, or a limited purpose.
Businesses will always prioritize near-term earnings and investments. Associations target bread-and-butter issues for their members over more complicated, long-range ones. Governments legislate and regulate to set guardrails around business solutions, but these policies merely enable or constrain business solutions. We still rely on businesses to create. Digital platforms are open. Users shape them.
There are many platforms for people in behavioral health to speak and be heard. Communication can be broad with both scholarly and passionate personal elements. No one vehicle for improving our field is best. Each plays a role. To make these arguments more tangible, let us consider how digital media can play a role in one of our field’s primary problems, access to care.
Digital Media in Action: Solving Care Access
Our field may be on the cusp of finally rectifying our access problem. Criticism has reached a crescendo, and both business and government leaders are focused on solutions. This does not mean all will be fine. Business is biased toward certain solutions. Government is not overly prescriptive about dictating solutions. Most of us lack a vehicle to influence our field’s direction on this. We need a bullhorn.
Access is an ideal problem for technology to solve. Investors are eager to fund the next big tech solution in healthcare. We have had a decade of investment in digital therapeutics, and artificial intelligence (AI) seems next in line. AI has been used for reducing administrative burdens, but now supportive chatbots may be on the horizon as they progress beyond familiar customer service functions.
Workforce expansion also makes sense. The federal government is ready with relatively limited funding. Innovative solutions focused on staffing primary care appear to be a growing focus. For example, we might place an array of licensed behavioral clinicians in this setting to do brief counseling and encourage digital self-help work. Who will ensure the best solutions get crafted and implemented?
The honest answer is no one—our field is not a hierarchical organization. Yet we need to reach health plans and health systems—they will buy the technology and staff the clinics. Reaching these business leaders is not easy, but this should be the goal. The digital bullhorn is one good way. There are many ways to combine workforce and tech solutions for better access. Whose values will prevail in this?
Digital media are a good way to craft strong arguments and rally the troops. Online posting may not replace traditional ways to accomplish these goals, but going viral beats growing complacent.
Ed Jones, PhD is currently with ERJ Consulting, LLC and previously served as president at ValueOptions and chief clinical officer at PacifiCare Behavioral Health.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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