Newsroom | Community Health

A woman pediatrician interacts with a young female patient who looks tentative but smiles.

Improving Behavioral Health Care Access

The need for behavioral health services is outpacing capacity, and primary care providers and insurers are looking for opportunities to prevent vulnerable patients from falling through the cracks.

Because of increased demand, 60% of behavioral health providers say they can’t accept new patients, despite being contacted by about 15 potential new clients a month, according to a 2022 American Psychological Association survey. Almost half say they can’t meet demand for treatment, and nearly 75% have longer waitlists than before the pandemic.

In Montana, where young people take their own lives at twice the rate of their peers countrywide, Dr. Sarah Holexa helped spearhead an initiative to train the state’s pediatricians and primary care providers to better evaluate and help their young patients with potential behavioral health issues.

“We see patients every single day seeking mental health care,” says Holexa, a Missoula pediatrician, but insufficient training, lack of time during appointments and limited referral resources prevented providers from doing so.

She and Kylee Bodley, executive director of the Montana Chapter of the American Academy of Pediatrics (MTAAP), worked to fund evidence-based behavioral health training providers there desperately needed. 

With support from Health Care Service Corporation’s (HCSC) Montana plan, MTAAP has begun helping dozens of providers get trained to better recognize and assist young patients with possible behavioral health issues, including depression and anxiety.

“We want all of our providers to feel equipped and to know what questions to ask."

The training initiative is among the strategies HCSC and its plans have employed to help members in Illinois, Montana, New Mexico, Oklahoma and Texas overcome obstacles to accessing behavioral health care resources, including:

  • Reminding network providers to conduct behavioral health screenings and offering them educational courses.
  • Providing community-based support group services to new mothers on Chicago’s South side.
  • Contracting with agencies in Illinois and New Mexico to reserve appointments to help ensure Medicaid members have access to mental health resources when they need them. 

With funding from the Montana plan and other contributors, behavioral health training will be offered to up to 45 Montana pediatricians and primary care providers annually for three years. So far, about 40 medical professionals, including Holexa, have received training through the REACH Institute, a nonprofit that offers mental health courses for health care providers to help better treat and manage patients with behavioral health conditions. The group meets monthly to follow up and review cases, as well as provide feedback and encouragement.

“As a health plan, making this investment to improve physician success directly affects patient engagement,” says Dr. David Lechner, the Montana plan’s vice president of vice president of health care delivery and chief medical officer. “I’m really proud HCSC is a principal sponsor of this meaningful effort.”

Overcoming mental health care challenges

The pandemic helped amplify a mental health crisis that’s overwhelming America, according to research by the Centers for Disease Control and Prevention (CDC). Nearly 22% of adults got mental health treatment in 2021, up from about 19% in 2019, the agency’s most recent data shows.

Despite increasing demand for services, only about 28% of the need for mental health professionals is met nationally, according to the U.S. Bureau of Health Workforce.

Recognizing that primary care and OB/GYN practices are entries into care for almost everyone, HCSC’s plans have reached out to network providers, encouraging them to screen members for potential behavioral health issues. The company also has offered providers a webinar series that includes instruction on screening for substance use disorders, assessing members with diabetes for depression, and understanding the risk of depression during and after pregnancy.

“We want all of our providers to feel equipped and to know what questions to ask,” says Cristy Steigerwald Rosendahl, a behavioral health professional and HCSC quality and accreditation process consultant.

Meantime, the Medicaid teams for the Illinois and New Mexico plans established a program to reserve appointments with licensed professionals for members with behavioral health conditions in need of follow-up care. Developed a few years ago, the Behavioral Health Advanced Appointment Program contracts with community mental health agencies to set aside appointments for Medicaid members to help ensure care continuity, while preventing emergency room visits and hospital admissions.

“We need to try to make sure members are in the right level of care,” says Olivia Emerick, a senior business consultant for the Illinois team.

Teaching mental and physical health advocacy

In 2021, nearly 9,400 of the Illinois plan’s Medicaid members gave birth. Most delivered with complications because of behavioral health conditions, substance use disorders or both. Additionally, members with behavioral health and substance use disorders were less likely to get prenatal care.

The revelations led a group of the plan’s medical directors, known as the Maternal Mental Health Work Group, to launch a new community-based group for mothers in communities of color to receive maternal health education and social support. Facilitators of the Mother’s Group, including a midwife and licensed behavioral health professional, lead discussions on topics such as about breastfeeding, exercise and depression.

The medical directors believe the Mother’s Group will provide an environment where participants can share experiences and information, ask questions, find peer support and learn to advocate for the medical and behavioral health services they need.

“They may not know how to prepare to give birth or what to expect during pregnancy,” says Dr. Dona Perry, a Mental Health Work Group member. “That’s why this education is so important for them.”

Health Care Service Corporation, a Mutual Legal Reserve Company.