5 biggest obstacles for behavioral health, per SSM Health exec

Behavioral health is projected to be one of the fastest-growing areas in healthcare, by market value, over the next few years. Those projections may fall short, however, if certain key obstacles aren't addressed.

Michelle Schafer, regional vice president and system clinical program chair for behavioral health at St. Louis.-based SSM Health, spoke with Becker's about barriers to growth in behavioral health services.

Editor's note: Responses were lightly edited for clarity and length.

Question: Behavioral health is projected to have a ton of growth over the next few years. Do you see obstacles or challenges that could jeopardize growth in behavioral health services, and why?

Michelle Schafer: The demand for behavioral health and substance use disorder services is at a critical level and I expect that demand to continue to grow. We are seeing volumes increase by nearly 20 percent from where we were before the pandemic. We are also seeing so much more acceptance, recognition and discussion about behavioral health, which is a good thing. However, there are also issues that could inhibit the growth of behavioral health services which then, in turn, will inhibit individuals from getting the help they need.

1. Access to care and providers

To increase access and staff the hospitals, units, and centers that are being invested in, we have to put effort into new models of care that allow us to spread resources among more people. We also have to invest in educating and training our workforce to increase the pipeline for providers. We must engage in “non-traditional” partnerships to assure that we are filling the void.

2. Telehealth: A mixed bag

Telehealth for behavioral health has been separated from the public health emergency, and the waiver for many exceptions has been continued until the end of 2024. However, we need to make those allowances permanent. We need payers to continue reimbursing for telehealth without significant limitations and rural stipulations beyond 2024.

However, this is both good for patients and a possible barrier…Many providers have moved from more traditional environments in clinics and hospitals to providing care via telehealth. This has contributed to our shortage…We cannot blame providers for making this move. It is our responsibility to address both the shortage, the models of care and the stress that accompanies the care in our facilities. 

3. Reimbursements

We will need to look at how behavioral health and substance use care are reimbursed differently. As collaborations between systems who use different funding mechanisms continue, funding agencies, state plans, insurance providers and CMS will need to be open to new ways of looking at funding care.

4. Trust between providers and underserved populations

Overcoming stigma and developing trust among our underserved populations still needs to be a focus and could jeopardize growth…We have to collaborate with the judicial system and law enforcement to ensure that people suffering from behavioral health and substance use issues get access to care and do not just get placed in jails. We must understand the different cultural needs and design programs to address them. Having a one size fits all program does not build trust.

5. Lack of collaboration and connectivity

We must as providers of care lean in together. We are much stronger together. We have to collaborate and not compete. We have to share information, ideas, success, clinical advances for the betterment of every person in every community — and in doing so, be good stewards of resources and provide the opportunity for everyone to get help earlier.

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