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APA Access Agenda Update: Connecting Patients to Care and Coverage

     

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This year, APA is sharing its #Access Agenda: three policy areas where the Biden administration and the new Congress can move the needle on mental health and addiction so that more people can get the high-quality psychiatric care they need. These areas are:

  1. Connecting Patients to Care and Coverage.
  2. Addressing Inequities.
  3. Investing in Mental Health and Substance Use Disorder Services.

This post addresses Connecting Patients to Care & Coverage.

During the pandemic, Americans have experienced higher rates of anxiety, depression, and substance use. Our country needs to meet the increasing demand for early identification and treatment of mental health and substance use disorders. If we do not address these illnesses early, they can lead to long term chronic issues, greater use of emergency rooms for treatment, or loss of life.    

The federal government took a tremendous step forward in December, when it created new authority for the Department of Labor to ensure that mental health and substance use disorders were covered by insurance (Read more here). Here are three more solutions to help meet the demand by connecting patients to care:  

Widespread Adoption of the Collaborative Care Model
The Collaborative Care Model is an evidence-based practice that provides mental health and substance use disorder services to patients through their primary care physicians. This model, already implemented in many large health systems and individual practices, can be the mental health equivalent of early detection of heart disease and cancer. It means that primary care physicians collaborate with psychiatrists on a team when they identify a mental illness in a patient. Over time, it’s an efficient and cost-effective way to ensure patients can access mental health and substance use disorder services when they need it.

APA supports incentivizing practices to adopt the Collaborative Care Model and establishing training and technical assistance centers for primary care practices on implementation of the model, so that it becomes more widespread.

Ensuring Telehealth Changes Are Permanent
Patients and doctors both adopted telehealth early in the pandemic. APA’s member psychiatrists reported that patients were satisfied with virtual care and that no-show rates were reduced. A recent study reported in Psychiatric Services also finds increased attendance at psychiatric appointments with the use of telepsychiatry.  Meanwhile, states and the federal government ensured that regulations were loosened so patients could more easily access care—for instance, psychiatrists could provide treatment without a seeing the patient in person first, telephone appointments were allowed, and psychiatrists were reimbursed for their virtual visits at the same rates as in-person, among other provisions.

These changes, if made permanent by Congress and the administration, will ensure more people can access psychiatric care quickly and without the hurdles in-person treatment sometimes presents.

Improving Access to Inpatient Psychiatric Beds
Providing inpatient care to patients with acute psychiatric symptoms is often a challenge given limited hospital beds. Many communities across the United States lack a comprehensive continuum of care that includes treatment services shown to improve outcomes for diverse populations. As a result, more people go to the emergency room for psychiatric care or linger on waiting lists for the treatments they need. 

APA is currently studying the availability of psychiatric beds to meet community needs, and is developing a model that states and communities can use to understand their needs. In the meantime, we back policies that take into account the need for inpatient psychiatric care. 

     

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