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Medicaid Waivers, Magic Mushrooms, and Other Texas Behavioral Health News

There are a lot of changes happening in Texas that could have significant implications for behavioral health. Here are some of the big mental-health stories impacting the Lone Star State.

Biden Administration Rescinds Changes to Texas 1115 Waiver

The Centers for Medicare and Medicaid Services (CMS) announced that it has rescinded an approval to extend a federal funding agreement, known as a 1115 waiver, with the state of Texas. Under the 1115 waiver, hospitals are reimbursed for “uncompensated care” provided to patients without health insurance. Texas has used it to pay for certain healthcare projects, including mental health services that serve low-income Texans.

The extension, originally granted late in the Trump administration, would have continued those hospital reimbursements until September 2030. The waiver now expires September 30, 2022. Reversing that decision pushes Texas toward expanding Medicaid, according to two federal health officials cited by the Washington Post.

Psychedelic Drugs for Veteran PTSD?

A proposed Texas House bill would order a study of the use of psilocybin, also known as “magic mushrooms,” to treat post-traumatic stress disorder (PTSD) in veterans. Texas Rep. Alex Dominguez authored the proposal, House Bill 1802, which is scheduled for public hearing.

The bill would direct the state’s Health and Human Services Commission (HHSC) to conduct the study with a health sciences university and a Veterans Affairs hospital. HHSC would also be asked to do a review of prior studies on the use of psilocybin, MDMA, and ketamine.

Lack of Maternal Mental Health Treatment Costs Texas Billions, Report Says

Mothers and children with untreated mental health needs cost Texas about $2.2 billion during the child’s first five years of life, new research says. The study, found that about 13.2 percent of pregnant or postpartum women had a maternal mental health condition in 2019. For each mother with untreated maternal mental health conditions, the average cost was $24,796 the first year after their child’s birth and $44,460 through the child’s fifth birthday.

Researchers calculated the cost by examining the cost of care for women with untreated mental health conditions, such as anxiety and depression, and the loss of income from work absenteeism. Cost of care tended to increase for children due to preterm birth, low birth weight, reduced breastfeeding, behavioral or developmental disorders, and other childhood heath issues.

A few of the recommendations from the report authors include:

Expanded funding for healthcare
Connecting pediatricians to psychiatrists for patient phone consultations
Increased access to group-based prenatal care and pediatric care programs

Harris Co. Sheriff’s Office Expands Mental Health Program

The Harris County, Texas, sheriff’s office is expanding a telepsychiatry program that allows law enforcement officers to respond more appropriately to mental health incidents. Under the program, a deputy uses an iPad to connect a person in distress with a mental health professional to help deescalate the situation.

In 2017, the Harris County, Texas, sheriff’s office became the first in the nation to invest in telepsychiatry. The program has grown from three deputies in 2017 to nearly 150 deputies in 2021. Sergeant Jose Gomez says the program is expanding to the office’s constable agencies.

Treating behavioral health and substance use clients in Texas? Make sure your EHR solution accounts for both state and federal documentation requirements. Contact BestNotes today to find out how our documentation features can help save you time and reduce frustration.

date:  Apr 29, 2021
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Five Common Trauma Therapies to Offer at Your Behavioral Health Practice

Mental health symptoms associated with the novel coronavirus pandemic could last months or years longer than the pandemic itself. Specifically, many individuals and families may seek out therapy to help with post-traumatic stress disorder (PTSD).

Symptoms of PTSD include nightmares, severe anxiety, flashbacks, or uncontrolled thoughts about a traumatic incident. If the symptoms get worse, affect daily life, or persist for months or years, it could indicate PTSD.

Who may need trauma therapy?

Trauma therapy may be helpful for individuals who have experienced a variety of situations associated with COVID-19:

Recovering from severe cases of COVID-19
Losing loved ones to the disease
Working directly with patients diagnosed with COVID-19
Disruptions due to school closures
Social isolation associated with stay-at-home orders, including experiences of domestic abuse
Job loss and other financial difficulties
Loss of or limitations to support services for mental health or substance use disorders
Increased consumption of negative news stories and social media, which can increase anxiety and fear

What can help individuals who have experienced trauma?

Here’s an overview of different types of evidence-based therapies often used for individuals who have experienced trauma.

1. Cognitive Behavioral Therapy (CBT)

A type of talk therapy, CBT examines a client’s thought patterns and how they influence behavior and choices. CBT helps clients pinpoint how some of their thoughts and behaviors have been incorrect or unhelpful.

Over time, clients can use CBT to develop more helpful, accurate thinking patterns and coping behaviors that can reduce symptoms and improve quality of life. For more details, check out our previous CBT post on the BestNotes blog.

2. Exposure Therapy

Exposure therapy can help clients confront and overcome their fears. Exposure therapy helps clients break patterns of avoidance by creating a safe environment in which he or she can face what they fear.

The BestNotes blog has a detailed post that provides a closer look at exposure therapy.

3. Narrative Exposure Therapy (NET)

A person’s life experiences and wellbeing heavily depend on the “story” that each individual tells himself or herself. With NET, a client can develop a fuller, more positive life story that appropriately contextualizes the traumatic event and how it has influenced him or her.

NET may help clients who have experienced complex and multiple trauma. One common use is among refugees, who have experienced trauma from “political, cultural or social forces.”

4. Eye Movement Desensitization and Reprocessing (EMDR) Therapy

EMDR is an evidence-based treatment for PTSD that helps clients process their trauma to aid healing. During EMDR sessions, the client focuses on a back-and-forth movement or sound while remembering an upsetting memory. The clinician also helps the client talk about and process their traumatic memories until PTSD symptoms decline.

5. Psychodynamic Trauma Therapy

Psychodynamic trauma therapy focuses on different factors that may affect or cause a client’s PTSD symptoms, such as experiences and coping mechanisms. This type of therapy focuses mostly on the client’s unconscious mind and how it influences behavior. Here, the therapist helps a client recognize and process painful, unconscious feelings so they can be released instead of being avoided.

Behavioral health clinicians may see a rise in demand for trauma-related therapies in the wake of COVID-19. Make sure you’re taking care of yourself as much as your clients with a customized EHR solution that helps you save time and reduce frustration. Contact BestNotes today to learn more.

date:  Apr 21, 2021
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What Should Behavioral Health Providers Know About Polyvagal Theory?

“Polyvagal Theory” describes a group of ideas related to the role of the vagus nerve in human psychology. According to this theory, the vagus nerve serves an important role in emotional regulation, social behavior, and fear response. Stephen Porges, director of the Brain-Body Center at the University of Illinois at Chicago, first introduced Polyvagal Theory in 1994.

What is the vagus nerve?

The vagus nerve, also called the pneumogastric nerve, is a cranial nerve made up of sensory and motor fibers. It is also the longest nerve of the human autonomic nervous system (ANS). The ANS controls and regulates many bodily functions, usually unconsciously. Such functions include heart rate, digestion, respiratory rate, and urination.

The ANS is important for the human body’s stress response and defense mechanisms. One branch of the ANS, the sympathetic nervous system, is connected to the “fight-or-flight” response. Another branch, the parasympathetic nervous system, controls what is sometimes called the “freeze-or-faint” response. In stressful situations, these systems may work together, or one may inhibit the other.

What is Polyvagal Theory?

Under Polyvagal Theory, human beings can immediately, even unconsciously decide if an environment is safe or threatening because of information sent via the vagus nerve.

When responding to their environment, Polyvagal Theory proposes that humans use not only the fight-or-flight and freeze-or-faint responses, but another division of the ANS. This third division includes a social communication and engagement system, which includes facial muscles, middle ear function, and vocalizing.

According to Polyvagal Theory, a person who, with the information sent via their vagus nerve, has determined that an environment is secure can feel safe in using their social engagement system. This includes a calm heart and respiratory rate, and the free use of vocal and facial expressions.

However, if the environment is not safe, it will trigger the fight-or-flight response. If that system somehow fails, then the freeze-or-faint response kicks in, and the affected person is less able to relate to the world socially. Porges also suggests that the body can remember a traumatic experience and become “stuck” in one of these trauma response states.

Polyvagal Theory in Mental Health

Psychologists and therapists who are interested in Polyvagal Theory often use it to inform decisions about anxiety, fear, and trauma.

According to Bessel van der Kolk, professor of psychiatry at the Boston University School of Medicine and author of The Body Keeps the Score, the Polyvagal Theory “makes us look beyond the effects of fight or flight and put social relationships front and centre in our understanding of trauma. It also suggested new approaches to healing that focus on strengthening the body’s system for regulating arousal.”

Because Polyvagal Theory is a relatively recent idea, supporting evidence remains limited. While it has been used to help inform trauma treatment, Polyvagal Theory has also been criticized for this lack of research. Additional research may be necessary before the theory is more widely incorporated into behavioral health clinical practice.

Trauma recovery is just one of many challenging areas for behavioral health providers. In particular, mental health and addiction treatment professionals can prepare to see an increased demand for services related to trauma connected to the COVID-19 pandemic.

You use different treatment approaches for different clients, so it’s important to make sure your EHR solution is just as flexible. BestNotes EHR solutions can be customized to your unique needs to help you save time, reduce frustration, improve profitability, and meet documentation and reporting requirements. Contact us today to learn more or schedule a demo.

date:  Apr 16, 2021
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This Spring, Consider the Link Between Green Space and Mental Health

Spring is finally here, bringing longer days, warmer temperatures, and new growth. As a behavioral health provider, this is the perfect time for you to encourage your clients to enjoy the benefits of green space.

Green Health Benefits

An increasing body of research shows that green spaces and nature can be a vital part of mental and physical health. For example, a World Health Organization report in 2016-17 noted that greenery and natural features can specifically help counteract the stress, lack of physical activity, and environmental hazards associated with urban living.

Experts have not yet determined exactly why we benefit from green space, but the effects are fairly obvious. Health benefits include:

Encouraging physical movement
Space to socialize (a notable benefit during the era of COVID-19, when people still need social interaction but many places have limited indoor gatherings)
Lower air and noise pollution
Exposure to beneficial microbes that can improve immune function
Reduced stimulation, leading to a more relaxed mind and increased ability to concentrate, remember, and learn

A Danish study published in 2019 suggests that, among those with behavioral health disorders, the benefits of green space may be greatest for individuals with mood disorders, depression, neurotic behavior, and stress-related concerns.

In fact, the study also found that children who grew up with the least exposure to green space had up to 55 percent higher risk of developing a psychiatric disorder. This was independent of other known risk factors.

Not Just Any Green Space

But are all green spaces created equal? Not necessarily, some research suggests.

One study in the United Kingdom, published in Frontiers in Psychology in 2018, found that biodiversity in urban green spaces was best for mental health. Study participants reported significantly more “psychological restoration” from urban parks with more biodiversity. Where mental health is concerned, parks with a variety of plants and other natural features are more beneficial than cultivated landscapes and modern amenities.

Different people also may respond to green space differently. One 2014 study found that the relationship between urban green space and health can vary by age and sex. Researchers report in the Journal of Epidemiology and Community Health that the benefit of more green space was most apparent in early to mid-adulthood for men. Among older women, those with moderate access to green space had better mental health.

Other research has found that green space access can have specific benefits for children. In the Journal of Pediatric Nursing in 2017, researchers reported that access to green space was associated with better health and cognitive development for children. Green space access was linked to attention and memory restoration, stress moderation, improved behaviors, and even higher standardized test scores.

Behavioral health clinicians can use these findings to encourage green space exposure and outdoor activities in clients of all ages. Consider discussing these benefits with your clients and working with them to determine the best outdoor locations and activities for their particular mental and physical health needs.

With behavioral health services in greater demand than ever, you need to strike the right balance between improving client outcomes, keeping your practice profitable, and staying compliant with regulatory bodies. BestNotes EHR solutions, built and customized specifically for behavioral health clinicians, helps you accomplish all three. Contact us to learn more about how our solutions can help your practice.

date:  Apr 12, 2021
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Lowering Suicide Rates, Reaching Rural Communities, and Other Utah Behavioral Health News

Each U.S. state is facing unique challenges in behavioral health, from substance abuse to the mental health effects of the pandemic response. Here’s a look at a few of the biggest behavioral health and addiction concerns in Utah, and how the state’s healthcare leaders are addressing them.

Expanding Mental Health Services in Rural Utah

The Huntsman Mental Health Institute (HMHI), part of University of Utah Health Hospitals & Clinics, is planning to increase access to mental health care services in rural communities throughout the state. To help fulfill its goals, HMHI has received $1 million from Oregon-based Cambia Health Solutions.

Mental Health America’s 2021 report (download the PDF here) found that Utah ranks last in the United States for adult mental healthcare access. Part of this is due to provider shortages, which particularly affects rural areas. HMHI plans to place psychiatry residents and fellows in rural communities, offer school-based psychiatric consultation, and partner with the university’s Department of Educational Psychology to provide mental health support and training in several community schools.

Addressing Suicide Rates in Utah

Utah lawmakers have passed several bills in an effort to address the state’s rising suicide rates. These include bills to:

Increase access to telehealth services, including raising Medicaid reimbursement rates for mental healthcare
Make nearly $16 million available to hire staff to implement 988 as a new phone line for mental health emergencies
Allow people who are experiencing a mental-health crisis to add their name to a “no-gun” registry and prevent firearm purchase for at least 30 days
Forbid police from shooting at people who are suicidal and a risk to only themselves
Provide about $1.6 million to educate care providers about mental health support for young children and fund family stabilization services

Utah to Receive Federal Behavioral Health Funding

Utah will receive almost $7.5 million for mental health services and $15.5 million for addiction treatment from the Substance Abuse and Mental Health Services Administration (SAMHSA). The agency is providing a total of $2.5 billion in block grants for states to address mental illness and drug addiction.

These block grant programs allow states to determine where they most need the money and how to address behavioral health issues, such as treating serious mental health conditions and preventing substance use disorder.

Utah Medical Clinic Now Offering On-Site Harm Reduction Services

The Odyssey House’s Martindale Clinic in Salt Lake City has become the first primary care clinic in the state to offer harm reduction services on its premises in addition to medical care. The clinic offers several different services related to substance misuse, including syringe exchange, prescriptions for medication-assisted treatment, and fentanyl test strips.

Such practices keep patients “coming back so that you can keep revisiting those notions of using drugs, less frequently, more safely, and not at all,” says Dr. Paula Cook, Chief Medical Officer for Odyssey House.

When you serve clients with substance use disorder, it’s important to know if your treatment plan is working. BestNotes EHR solutions, including our OutcomeTools system, were designed to address the needs of both your practice and your clients. Contact us today to learn how BestNotes can help your behavioral practice succeed.

date:  Apr 05, 2021
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