The crisis surrounding mental and behavioral health threatens to overwhelm the community.
In 2019, 47,511 Americans died by suicide, and since 2016, suicide has been the second leading cause of death for those ages 10 to 34. Substance use disorder is rampant, and overdose deaths in Indiana are rising.
But despite the prevalence of these issues, people are not receiving the care they need. According to the National Council for Behavioral Health, just 12% of Americans with a substance use disorder receive specialty treatment in any given year. Just 43% of all people living with mental illness receive treatment for their condition.
“Mental health issues have been growing for some time, and often there are unmet needs,” said Dan Arens, chief operating officer for Adult & Child Health. “Statistically, people with serious mental illness die 25 years younger than those without. And that’s not because of mental illness, but because of unmanaged chronic disease and just falling through the gaps of the health care system.”
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In the coming months, Adult & Child hope to fill in some of those gaps. The central Indiana mental and behavioral health organization has been awarded a $3.9 million grant to allow it to provide the most extensive mental health care possible in Johnson and Marion counties.
Patients will be able to come to Adult & Child’s Franklin office to receive same-day behavioral health care, mobile crisis services, treatment with medication for opioid use disorder as well as primary care screenings and case management.
The hope is to provide more comprehensive care to the most vulnerable patients in the county, Arens said.
“We can provide the right care for the right person at the right time,” he said. “We feel like we’re proactive in adapting our mental health system to do integrated care, and the timing of this is impeccable.”
On top of the existing increases in mental and behavioral health issues, the past year has highlighted the areas where more help is needed.
Depression and anxiety have skyrocketed in the past 12 months, exasperated by the pandemic. People haven’t had the connections they need to help.
Calls to Adult & Child’s help line have nearly doubled for people calling for more access.
“People need that connection, even if it’s just being able to talk to someone on the phone and get some things off their chest, to reset mentally, we’ve seen a huge need for that,” Arens said. “COVID aside, there was an increase in need. But COVID has certainly brought on even more.”
The movement toward Certified Community Behavioral Health Clinics helps address the gaps in the health care system. The model aims to dispel significant challenges that have led to a crisis in providing access to mental health and addiction care, according to the National Council for Behavioral Health.
The effort has been designed to standardize access and quality of care for mental health, substance abuse and people who have both of those issues, Arens said.
Through this model, the clinics ensure access to integrated, evidence-based addiction and mental health services, including 24/7 crisis response and medication-assisted treatment for addiction.
“The Certified Community Behavioral Health Clinic program … (is) making services more convenient. They’re introducing more frequent appointments, tailoring services offered to diverse populations such as school-aged youth and veterans, and they’re expanding access to care in our communities," said Alex M. Azar II, Secretary of the Department of Health and Human Services, during a Senate Finance Committee hearing Feb. 13, 2020.
Qualified clinics meet stringent criteria regarding timeliness of access, quality reporting, staffing and coordination with social services, criminal justice and education systems.
Currently, 340 such clinics are operating in 40 states, plus Washington, D.C. and Guam.
In other states that have implemented a Certified Community Behavioral Health Clinic format, data has shown that the community is better cared for and that police runs and emergency room stays are decreased.
In mid-February, the Substance Abuse and Mental Health Services Administration announced grants totaling $4.25 billion to 134 clinics around the country, including Adult & Child. The money allows Adult & Child, as well as nine other clinics throughout the state, to become Certified Community Behavioral Health Clinics.
“Indiana is leading with the number of mental health centers that have (Certified Community Behavioral Health Clinic) designation. We’re confident outcomes will show that the CCBHC approach is a superior model for the mental health and addictions safety net,” said Allen Brown, president and CEO of Adult & Child Health.
The grant will provide opportunities to fund care they’re currently unable to due to cost.
Mental health centers, such as Adult & Child, are funded on a fee-for-service basis, Arens said. That means that, though there is some funding from state government as well as a small amount of help from county government, the costs of treatment comes mostly from insurance — Medicaid and Medicare.
At Adult & Child, 8% of patients are low income or have no insurance at all, Arens said.
The grant will help Adult & Child offer better access to better care throughout its health care system.
“We can have the grant pay for community outreach or after-hour crisis teams that we can’t afford to have, as kind of a seed fund for us to demonstrate that it works,” Arens said.
The expanded services created by this model are aimed at those most at risk to mental health issues, including individuals with serious mental health or addiction, including opioid disorder. Emphasis is also on children and adolescents with serious emotional disturbance, as well as those who have co-occurring physical health disorders.
The $3.9 million grant is spread out over two years. Funding should be available after that time period to continue the program, Arens said.
Over the next four months, Adult & Child will go through a lengthy and intensive certification process, which they expect to be completed by June. Leaders are also going to hire additional staff that would be front-end screeners to give those who are calling help walking through their needs and what kinds of services are best for them, Arens said.
They will also hire crisis therapists to provide assistance.
“The basic premise is that we can hire more people and get rid of waiting lists that we’ve had because of lack of funding,” Arens said. “It will help us open up and better serve the counties we serve.”
