The stigma around seeking mental healthcare could creep back if treatment is too difficult to access, said one behavioral health leader.
Kenneth Nash, MD, is chief of clinical services at UPMC Western Psychiatric Hospital in Pittsburgh.
"When you're really depressed, it's hard enough to make that first phone call. I'm afraid that our biggest factor right now is stigma going back up, if we don't get the access so people can get care when they need it," Dr. Nash told Becker's.
Walk-in clinics, group intake sessions and telehealth sessions have improved availability of care, Dr. Nash said. Behavioral health providers need to take a closer look at throughput to get more people into care, he said.
"I want people to get adequate care, but I think other parts of medicine are really progressing around throughput, and as psychiatry, we really haven't had a discussion about it," he said.
Models of care need to be challenged or rethought over the next several years, Dr. Nash said, to get more people access to behavioral providers.
"When somebody is doing much better, functioning better, less symptomatic, do we work on ways to wean them out of therapy and into a lower level of care?" he said.
Another key component to providing behavioral health access is making sure behavioral health providers are in adequate supply, and that they are properly trained.
Dr. Nash said he's recruited more than 100 psychiatrists to UPMC Western Psychiatric and the surrounding community in recent years. Compensation is one factor in recruiting and retaining psychiatrists and other mental health providers, but ensuring they feel competent and confident is another, he said.
"That's partly about getting good mentorship and supervision with people who have experience," Dr. Nash said. "In mental health, sometimes we have this problem where people are junior, but they don't have a way to connect to a senior clinical psychologist or psychiatrist right off the bat."
Dr. Nash said, at UPMC, psychiatric residents are immediately connected with a mentor , who helps them navigate through their first six months. Turnover of psychiatrists was around 2% in the past year, Dr. Nash said, which he credits to a combination of compensation and strong mentorship.
In addition to retaining providers, it's important to train providers that will treat the populations most in need of care.
"You want to have a training program that has exposure to the whole population, so when they leave, they don't just go to the cash, commercial population," Dr. Nash said. "We put a lot of people in community psychiatry, working in community centers, with Medicaid patients — I'm very proud of that."
"You want to have an increased workforce, but you also want the workforce that will have the biggest impact."