The pressure test coming for behavioral health, per CVS Health's top psychiatrist

The next five years will be a pressure test for what works and what doesn't in behavioral health, according to CVS Health's top psychiatrist. 

"Through the pandemic, a lot of companies started up, and they have wonderful care models on paper, but right now, it's not clear exactly what provides a superior clinical outcome," Taft Parsons, III, MD,  chief psychiatric officer at CVS Health told Becker's. 

Dr. Parsons has been chief psychiatric officer at CVS Health since 2022. He sat down with Becker's to discuss CVS's efforts to expand access to behavioral care, the current state of mental health and more. 

In the coming years, tools and non-clinical workers, like peer supports, community health workers and digital tools, will play a larger role in behavioral health, Dr. Parsons said. Insurers, like CVS subsidiary Aetna, will be paying close attention to see what delivers results. 

"I think over the next few years, us and other insurers are going to be working with a lot of these companies to really pressure test those models of care," he said. 

The next five years will bring more focus on what constitutes high-quality care in behavioral health as well, Dr. Parsons said. 

"There's going to be an increasing focus on what actually happens outside of just a unit of service delivered, to really demonstrate that the clinical care being provided is of high quality," he said. 

Behavioral health's two-fold problem 

A recent survey from CVS Health found two-thirds of U.S. adults have concern about their own mental health or the mental health of friends and family, up 15 points from 2020. 

Dr. Parsons said the findings in the survey weren't necessarily surprising, but indicate the continued growing need for behavioral care. 

There is an "absolute shortage" of behavioral health providers, Dr. Parsons said. One possibility to help ease shortages CVS is exploring, he said, is supporting individuals who have the education to become an independently licensed clinician, but are unable to complete the number of clinical hours needed to get their full licensure. 

Though many areas of the country have a major shortage of providers, some clinicians in Aetna's network have open appointments, Dr. Parsons said. The second challenge is connecting people who need care to providers who have space. 

"How do we navigate folks to the care that actually is available?" Dr. Parsons said. "How do we make it easier for them to identify the things that are important to them, be it understanding of race and ethnicity, religion or some other factor they feel is going to be important in their treatment?" 

Opportunities for action 

Though access to care remains a significant barrier, more behavioral health treatment is taking place in outpatient facilities, primary care offices and online than before the pandemic, Dr. Parsons said. 

Primary care can offer an opportunity to address mild mental health concerns, Dr. Parsons said, but primary providers need to be supported in dealing with more complex cases. A focus for CVS in the coming years is making it easier for primary care providers to refer members into specialty care. 

"We expect that over time, PCP's are going to need to be more comfortable managing very mild to moderate behavioral issues in the same way that a PCP is comfortable managing hypertension, but maybe not advanced heart failure," Dr. Parsons said. 

CVS Health, the nation's second-largest healthcare company, touches almost every part of the healthcare system, including insurance, pharmacy and primary care. In addition to coordinating behavioral care for Aetna members, CVS is expanding its behavioral health provider offerings. 

MinuteClinic, the company's retail walk-in sites, offer behavioral care in 14 states, and more virtually, Dr. Parsons said. CVS also acquired Oak Street Health, a primary care provider that mainly serves older adults, in 2022. Oak Street sites are focused on integrated care, Dr. Parsons said, providing behavioral health, physical health and social support in one location. 

Silver linings 

As a clinician, Dr. Parsons said, he's feeling optimistic seeing more patients receive outpatient care. 

"The only good thing that happened though the pandemic is that, for whatever reasons, people suddenly got much more comfortable talking about emotional and mental health struggles," he said. "I think we've had a significant decrease in the way that stigma has traditionally prevented people from seeking care." 

People are more comfortable requesting care from the health insurer, primary care providers, and talking to their friends and family about mental health, he said. 

"We see in the data that significantly more care is being delivered," Dr. Parsons said. "I think it's really starting to meet a need that has been under the radar for a very long time." 

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