In my two decades of working in mental health policy, I have never been more hopeful than I am today.
Mental health is truly the “bipartisan issue of our time.”
Indeed, there has never been a more opportune moment for transformative actions to advance quality mental health solutions. The stigma around mental health is receding, more people in need are asking for help, and more organizations are raising their hands to be part of the solution, as evidenced by recent record-setting investments from the public and private sectors.
One of the solutions my colleagues at the Meadows Mental Health Policy Institute and I are most excited about is the integration of specialty behavioral health care into primary care and pediatric settings.
The Collaborative Care Model, considered the “gold-standard” of integrated care, provides for the routine screening and early detection of mental illnesses (just like other conditions such as high blood pressure), and enables intervention when conditions are easier to treat.
Over 90 randomized controlled trials have demonstrated that Collaborative Care increases access to mental health care and is more effective and cost efficient than the current standard of care for treating common mental illnesses such as anxiety and depression.
I am especially enthusiastic about Collaborative Care’s potential to alleviate the country’s youth mental health crisis, as my colleague Melissa Rowan and I recently wrote in a joint blog post with Rachel Nuzum of The Commonwealth Fund.
To capitalize on this positive momentum, however, we must address our antiquated behavioral health technology infrastructure, a theme I heard echoed throughout November’s Going Digital: Behavioral Health Tech Conference.
With the passage of the Health Information Technology for Economic and Clinical Health Act, known as the HITECH Act, in 2009, the federal government mandated the creation of electronic medical record systems throughout health care facilities.
This modernization of our technology infrastructure catalyzed health systems’ ability to support busy clinicians in assessing risk, prescribing medications, and monitoring care protocols and outcomes, by allowing doctors to instantly access and review patient history and leverage care supports and prompts, such as automated reminders for screening and risk factors. It also facilitated population-level understanding and advancements in what was more likely to be working—and not working—in health systems across America. Patients now experience direct benefits as their medical histories and records can now follow them more easily between different clinical settings. Moreover, individuals have seen notable improvements in outcomes for major illnesses such as heart disease and cancer over the past decade.
But unfortunately, that landmark legislation did not include behavioral health care providers. As a result, today, more than a decade after the passage of the HITECH Act, many behavioral health providers still use recordkeeping systems that rely on rudimentary technology such as paper and fax machines and cannot be integrated with other health care records. The past decade has also seen dramatic declines in behavioral health.
In partnership with Going Digital: Behavioral Health Tech, and with funding from The Commonwealth Fund, the Meadows Institute produced a white paper last May recommending that the Office of the National Coordinator for Health Information Technology (ONC) develop security, interoperability and privacy standards to address this gap.
During one of the policy track sessions I moderated at November’s conference, I was encouraged to hear ONC announce a partnership with SAMHSA to invest $22 million into behavioral health tech integration. While this is an exciting development, a significantly larger investment will be critical.
That is why my organization is proud to be leading an effort to unite a diverse coalition of partners from across the health care spectrum, including Going Digital: Behavioral Health Tech, Hopelab, and GreyMatter Capital, behind a plan to generate a legislative solution to this challenge.
To that end, we sent a joint letter last month to the United States Senate Committee on Health, Education, Labor and Pensions urging it to include provisions to support behavioral health providers’ adoption and use of electronic health records as part of the SUPPORT for Patients and Communities Reauthorization Act.
We are grateful that the HELP Committee passed the SUPPORT Act, which included language to require the ONC to convene an expert roundtable to “examine how the expanded use of electronic health records among mental health and substance use providers can improve outcomes for patients in mental health and substance use settings and how best to increase electronic health record adoption among such providers.”
This language is a positive step toward modernizing information systems for behavioral health providers and integrating behavioral health with primary care. But we must not stop here.
We cannot ensure proper care for people with behavioral health needs when providers are not able to use advanced technology to coordinate patient health records.
With the help of our partners, we look forward to pushing for the full passage of the BHIT Coordination Act, S.2688/H.R. 5116, which supports behavioral health providers’ efforts to adopt health information technology systems.
I invite more behavioral health technology companies to join our coalition. Together, we can achieve a transformative solution for this challenge and grasp the unprecedented opportunities that lie within reach for the behavioral health system.
Kacie Kelly is the chief innovation officer at the Meadows Mental Health Policy Institute. @KacieAKelly