Mimi McFaul, Psy.D. Director WICHE Mental Health Program

Transcription

1 Is your SORH thinking about whole health? Mimi McFaul, Psy.D. Director WICHE Mental Health Program ALASKA ARIZONA CALIFORNIA COLORADO HAWAII IDAHO MONTANA NEVADA NEW MEXICO NORTH DAKOTA OREGON SOUTH DAKOTA UTAH WASHINGTON WYOMING This Presentation Brief rural behavioral health overview Importance of behavioral health to health Snapshot of rural behavioral health opportunities At what intersections can you can have impact 1

2 Chaotic Time of Opportunity Healthcare reform tide Everyone scrambling National decisions that will trickle down to states State-based decisions that will drive local care Are rural and behavioral health at the table? The Facts: Mental Health Approximately 1 in 4 adults have a diagnosable mental disorder in a given year 1 in 17 lives with a serious mental illness (e.g., bipolar, schizophrenia) 50% of all lifetime cases of mental illness begin by age 14 & 75% by age 24 Less than 30% of adults and 50% of children with a diagnosable mental disorder receive mental health services in a given year 2

3 Rural Behavioral Health Similar issues to rural health access, availability of providers Prevalence of mental health issues overall not that different (rural vs. urban) with some exceptions by specific condition (depression) or substance Stigma More than 40% of recent war veterans return to rural areas Rural Behavioral Health Higher suicide rates in rural areas Approximately 57% of the federally designated mental health professional shortage areas are in non-metropolitan counties. True picture of behavioral health professional workforce is limited by a lack of reliable data for the mental health professionals 3

4 Rural Behavioral Health Increase in Medicaid eligibility = opportunity and places demands on the system (e.g., workforce) Medicaid is vital to financing behavioral health services that would likely be otherwise unavailable in rural communities. Finances almost half of the publicly provided mental health services in rural areas. Important source of revenue for primary care providers & Community Mental Health Centers in rural Acknowledging distinct issues that have significant overlap: Whole Health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, June, 1946 Physical Mental/Emotional 4

5 Mental Health Expenditures Spending on Behavioral Health (Mark et al, Health Affairs, 2011) 5

6 The Role of Behavioral as a Determinant of Health Access to Care (10%) Genetics (20%) Environment (20%) Health Behaviors (50%) CDC, published in Health and Health Care 2010, The Institute for the Future Behavioral Health has leverage in the system! Behavioral health conditions are implicated in all major chronic diseases, and vice versa Many high ER users have a mental health or substance use disorder issue Many people, especially in rural, access mental health care via primary care 6

7 How can the WICHE Mental Health Program assist with rural behavioral health opportunities? Building rural training sites: APAaccredited rural psychology internship consortia (AK, HI) Suicide prevention training for rural primary care practices Consultation on integrating care Telehealth/Telebehavioral Health Mental Health First Aid (MHFA) training for community/lay people Connecting you to other resources/experts Questions to Consider What are some of the key issues in the rural areas of your state? Lack of rural training opportunities in BH? Suicide? Where can you have impact? Emergency responders? National Guard/Reserve Component members? Primary Care 7

8 Questions to Consider What's happening with integrated care in rural areas of your state? What are rural FQHCs providing? (One-third of FQHC service sites are in rural communities) Does your state have a SAMHSA/HRSA PCBHI grant? Are medical homes including behavioral health? Questions to Consider How is your state utilizing telehealth for behavioral health? Are leaders in rural and behavioral health in your state involved in healthcare reform planning - Medicaid expansion, Essential Health Benefits, Health Insurance Exchanges? 8

9 Some Trends to Watch as they Evolve Integrated Care What strategies work the best for rural communities? What payment models will be the most effective and be sustainable? More focus and funding for Prevention how do we do this and what does it look like? Some Trends to Watch as they Evolve Workforce Issues Even more significant shortages of behavioral health capacity with increase in people eligible for Medicaid Different system = need for different training models and competencies Who can do what (scope of practice) & who will pay for whom (reimbursement for different provider types), Multidisciplinary training - how and where to do this? Many people believe they work (well) in teams integrating care tests this 9

10 Some Trends to Watch as they Evolve Leadership Who will emerge as leaders? How do we foster leadership development in a new era of healthcare? Especially necessary for behavioral health and rural to have a voice. Rural Behavioral Health Resources National Association for Rural Mental Health (NARMH) Maine Research Center UNM Center for Rural and Community Behavioral Health Center for Rural Health at UND WICHE Mental Health Program - Contact us and we will help connect you! 10

11 Questions? Contact Information: Mimi McFaul, Psy.D. Director, WICHE Mental Health Program Boulder, CO 11