How Providers Can Deal With the Behavioral Health “Pandemic”

As the novel coronavirus pandemic is on the decline, another crisis continues to threaten individual and public health. Behavioral health concerns, from depression to eating disorders to substance abuse, are on the rise, and many providers are unprepared to tackle the increased demand for treatment services.
Not Enough Mental Health Providers
The mental health effects of the COVID-19 pandemic response could linger for months or even years. Many individuals, such as frontline healthcare workers or those living in social isolation, have been suffering from anxiety and trauma.
A new report released by the U.S Government Accountability Office (GAO) describes how behavioral health concerns increased during the pandemic. At the same time, treatment access decreased.
The Centers for Disease Control Household Pulse conducted a survey from April 2020 to February 2021, finding that 38 percent of adults reported symptoms of anxiety or depression. This is an increase from 11 percent in 2019. Emergency room visits for overdoses and suicide attempts also increased by 36 percent and 26 percent, respectively.
The GAO report also noted that the Health Resources and Services Administration designated 5,700 mental health provider shortage areas. As of September 2020, one-third of Americans lived within these areas.
Public health experts have been warning about a shortage of mental health and addiction treatment services for years. During COVID-19, however, providers also experienced financial difficulties that led them to lay off staff and limit services. Because of social distancing requirements, many inpatient facilities reduced the amount of inpatient beds.
The ongoing behavioral health staffing shortage has become a vicious cycle. Existing behavioral health staff are experiencing burnout and fatigue, leading to higher turnover that can perpetuate staffing issues. Low pay has also hindered the ability to hire new staff members.
Options for Easing the Behavioral Health Burden
Although not the ultimate, catch-all solution, telehealth is one vital tool at providers’ disposal. The technology expanded rapidly during the early days of the pandemic, but even though more facilities are back to seeing in-person patients, many providers continue to expand telehealth to help meet demand.
Closer coordination between primary care and behavioral health could also help expand care. This could be the perfect time for hospitals, health systems, and others in the industry to try out different care integration models. Urvashi Patel, PhD, chief analytics officer at New York-based Brighton Health Plan Solutions, suggests that behavioral health specialists may work out of a primary care site, or work as part of a team managing individual patients.
In many states, non-physican clinicians, such as advanced practice nurses and physician assistants, can practice independently. Encouraging and advocating for these types of providers, even seeking legal changes to expand their practicing privileges, could also help meet behavioral health demand. Partnering with other behavioral health organizations, such as support groups and religious organizations, may also help get clients the support they need and ease providers’ workloads.
In Virginia, state-run psychiatric hospitals are considering several options to address overwhelming staffing shortages. Hiring additional security staff to help reduce risk for employees is one short-term solution. In the longer term, lawmakers are considering an increase for Medicaid reimbursement rates, particularly for private hospitals to encourage them to accept Medicaid patients.
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