We have tools that identify, treat, and support recovery or management of mental health disorders and substance use disorders (SUDs). But too often, those who would benefit most from these tools can’t access them. This is primarily due to cost, a lack of available professionals, and too few services that emphasize the potential of community- and family-based care. For example, more than 85% of counties in the United States do not have enough mental health professionals to meet the needs of the population. To make matters worse, mental health services are less likely to be covered by insurance. Even when an individual with a mental health disorder or SUD is able to access treatment, it may not be evidence-based, effective, or appropriate to their needs.
While there are interesting innovations, such as those delivered via telemedicine approaches, this strategy aims to increase systems capacity to deliver evidence-based, effective, and appropriate care for all. For funders choosing to implement this strategy, the following approaches can close gaps in access.
Workforce Expansion Programs
High turnover rates, an aging workforce, mental and emotional burnout, and low compensation have resulted in a severe shortage of professionals who treat individuals with mental health disorders and SUDs, particularly in rural counties. Funders can support telemedicine; provide or advocate for better financial incentives to young providers (e.g.: scholarships, loan forgiveness, loan repayment programs, service corps); and support the training of non-specialist providers (e.g.: peers, patient navigators, social workers, religious leaders, and community health workers). Philanthropic funding can also go towards incorporating peer specialists into integrated programs and increasing existing providers’ capacity to provide modern, culturally appropriate care to diverse populations.
Crisis Response Services
The United States is currently facing a widespread increase in drug, alcohol, and suicide deaths. Effective crisis response services include suicide prevention hotlines or warmlines, 23-hour crisis stabilization/observation, short-term residential stabilization, peer services, and mobile crisis services. Community-based, comprehensive care facilities that are available 24/7, 365 also yield positive benefits including significantly fewer visits to the emergency room and greater access to long term care. These services save lives and provide significant cost savings since they can divert people from more costly psychiatric hospitalization. Funders can support these services directly or advocate for appropriate coverage of services provided.
Integrated Health Care
In comprehensive integrated care models, psychiatric physicians, primary care physicians, and other health providers work with patients and families to provide coordinated person-centered care. This can include universal mental health screening, appropriate sharing of health information, support for self-management and treatment, connections to specialists, and support for co-management of co-occurring conditions, such as cancer and heart disease. Integrated care has been estimated to save $26 to $48 billion annually in general healthcare costs, due to reduced spending in treatment facility and emergency room expenditures. Other benefits include increased diversity of treatment, closer collaboration between providers, and most importantly, better outcomes. Funders can directly support the above practices, which provide integrated care, or they can advocate for policies that reduce barriers to providing such care.
Family Support and Involvement Groups
When family and friends are able to provide needed care to people with mental health disorders and SUDs, it reduces symptoms, and in certain cases, the need for specialized clinical care. However, to be effective, caregivers need skills to recognize symptoms, and intervene effectively when appropriate. They also need help dealing with the enormous emotional and mental toll of caring for someone with a chronic condition. Funders can support group and family programs that provide both practical resources and emotional support, or they can advocate for better reimbursement of these programs by insurance plans.