Increase access to evidence-based treatments for substance use and mental health disorders in specialty and primary care.
We must expand the effective identification and treatment of behavioral health conditions in specialty and primary care. Effective care models exist to treat many individuals with substance use and mental health disorders in primary care. Public and private stakeholders—policymakers, payers, accreditors, and others—should take the steps needed to make these effective practices the standard of care. One evidence-based approach to addressing behavioral health in primary care is the Collaborative Care Model.
Advancing Priority 2
Ensuring people have access to care—when and where they need it—is critical to the overall health and well-being of Americans. The National Response is advocating for the permanent use of technology to increase access to screening, treatment, and primary care, especially for hard-to-reach communities.
A hard look at the landscape is helping to identify effective Collaborative Care Models that can be replicated nationwide, measurement-based care in mental health addictions and reimbursement, and win-win public-private partnerships with companies that innovate in electronic health records. Funding and legislation are needed to institutionalize and set these strategies up for success, including making telehealth services for behavioral health care permanently accessible and reimbursed as a covered service.
Priority 2 Calls to Action
We call on state and federal insurance regulators and Medicaid agencies, to enforce the Mental Health Parity and Addiction Equity Act and ensure that health plans are covering mental health and substance use disorder services in a nondiscriminatory manner, including proper coverage of services necessary to treat chronic mental health and substance use disorders consistent with generally accepted standards of care.
Expand the effective identification and treatment of individuals with mental health and substance use disorders in primary care and via innovative specialty care.
- We call on federal and state policymakers and commercial payers and health systems to take specific steps to enable and incentivize wider availability of the Collaborative Care Model (CoCM), which has been shown across more than 79 randomized controlled trials to be effective in improving outcomes related to depression and anxiety, medication use, mental health quality of life, and patient satisfaction, when compared to usual care. Use of the model is currently supported by Medicare, many commercial payers, and some state Medicaid plans, and is facilitated by designated Current Procedural Terminology and Healthcare Common Procedure Coding System billing codes.
- Where CoCM is not the preferred model, we call on federal and state policymakers and commercial payers and health systems to take specific steps to improve outcomes for individuals with serious mental health and substance use conditions in through the use of effective methods for integrating mental health and substance use treatment in primary care.
- We call on federal and state policymakers and commercial payers and health systems to take specific steps to improve outcomes for individuals with serious mental health and substance use conditions through the use of models such as Certified Community Behavioral Health Clinics that—in coordination with physical health care—provide 24-hour crisis care and integrate mental health and substance use treatments and services in specialty care.
Require the use of measurement-based care for mental health and substance use disorders in both specialty and primary care systems in order to qualify for maximum reimbursement.
- We call on federal and state policymakers and associations of government leaders responsible for mental health and substance use disorder services to ensure a widespread understanding (e.g., among advocates, families, and patients) of measurement-based care (MBC, the systematic evaluation of patient symptoms before and during a visit to inform decisions about care) as necessary for effective care.
- We call on relevant health care accreditation organizations to require the use of MBC as an accreditation standard for organizations providing specialty care for mental health and substance use issues, and for general medical care providers when they treat individuals for mental health and substance use issues.
- We call on all professional associations representing clinicians who treat mental health and substance use issues, and those representing inpatient and outpatient health care facilities and systems in which individuals receive care for mental health and substance use issues, to adopt MBC as a standard for their members.
- We call on public and commercial funders and payers, including employers and philanthropic entities, to ensure that quality metrics and technological advances that are meaningful to the care of individuals with mental health and substance use disorders—particularly standardized patient outcome tools—are required and incentivized.
- We call on all relevant health system stakeholders to ensure that specialty and general medical providers who treat individuals identified with suicide risk are trained, expected, and incentivized to provide safety planning that includes lethal means counseling.
Make telehealth services for mental health and substance use disorders permanently accessible and reimbursed as a covered service.
- We call on federal and state policymakers and commercial payers to make telehealth services for mental health and substance use issues permanently accessible and reimbursed as a covered service by continuing the waivers currently in place in response to the pandemic. This includes enabling providers to practice across state lines and ensuring full reimbursement at parity with in-person services for outpatient levels of care, such as the Intensive Outpatient/Partial Hospitalization Program and traditional outpatient treatment.
Priority 2 Work Group
Priority 2 is one of six strategic imperatives the National Response has identified to help transform mental health and suicide prevention nationwide in the wake of the pandemic and beyond.
The co-leaders of the multi-sector Priority 2 Work Group are:
- Ms. Karen Johnson, Senior Vice President, Clinical Services and Behavioral Health Compliance Officer, Universal Health Services, Inc.
- Ms. Linda Rosenberg, Director of External Relations, Department of Psychiatry, Columbia University
- Dr. Michael Schoenbaum, Senior Advisor, Mental Health Services, Epidemiology, and Economics, National Institute of Mental Health [c]
Please visit this page often for progress updates and for information on how you can get involved