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Why we need a wholistic approach to behavioral health

I’m not proud to say that in the past, I’ve played a role in cutting behavioral health programs in an effort to navigate budget constraints and mitigate financial losses. But my perspective as a finance executive is not what it used to be.

 

I’ve worked in health care for more than 30 years, serving in various roles in and outside of finance. I’m not proud to say that in the past, I’ve played a role in cutting behavioral health programs in an effort to navigate budget constraints and mitigate financial losses. I’ve seen other health executives and systems do the same.

It wasn’t until about 10 years ago, when my own niece needed these programs, that I discovered the lack of an adequate care infrastructure. I’ve been living with that personal guilt for a decade.

Florida, our family’s home state, ranks 48/50 in access to care by Mental Health America. My organization, AdventHealth, regularly conducts Community Health Needs Assessments (CHNAs) in Florida and the other states in which we operate. In terms of identified needs in the CHNAs from across the system, mental and behavioral health are chosen 70 percent of the time as an area to address in our communities.

Add this to existing issues negatively impacting Americans and people around the world (e.g., a global pandemic, racial unrest and political division), resulting in a major crisis on our hands. If there was ever a time that we should see the need for behavioral health resources, it’s now.

We All Know Someone Who Struggles with It
Behavioral health is an umbrella term for a variety of conditions, including anxiety, personality disorders, learning and developmental disorders, trauma, addiction and more. Each one of these components breaks out into subcomponents. In some cases, these conditions may manifest themselves in alcoholism or bulimia; in others, in panic attacks or depression.

As a member of AdventHealth’s Behavioral Health Steering Committee and chair of its employee workgroup, I recently shared a presentation with our executive leadership team that included an eye-opening statistic from our short-term disability provider: 42 percent of mental illness disability claims are related to depression.

And yet, at times it seems like we’re not openly talking about this. Whenever we suffer from other ailments, we’re very likely to ask colleagues or friends for recommendations on specialists like cardiologists. Unfortunately, that doesn’t seem to be the case for psychiatrists or therapists. The truth is, it doesn’t matter who you are – what gender, race or socioeconomic status you come from ­­– we all know someone who struggles with behavioral health, and sometimes it’s ourselves.

It takes real courage to be in a position of leadership and admit that you struggle. If you happen to be one of those individuals, show that courage.

For the Good of Our Health and Our Communities
The science is very clear: Depression exacerbates other medical issues. That’s because the components of our health – body, mind and spirit – are interconnected.

How can we address this? We need to be better at using our primary care network to meet the behavioral health needs of our communities, as well as the behavioral health resources we provide to our health system team members.

The health care industry needs to be thinking about behavioral health more “wholistically”, which is why I like the idea of utilizing primary care. A study several years ago revealed that 45 percent of suicide victims had seen their primary care physician (PCP) within 30 days of taking their life. The Collaborative Care Model allows PCPs to manage mild to moderate severity behavioral health patients with the assistance of a care manager and consultation of a psychiatrist. It surrounds PCPs with a team so they don’t have to do it all themselves.

It’s important that we also engage community partners to see how we can get them to lean into these issues. No single organization should be tackling this on its own. We should partner with other health systems and city and county governments to put a comprehensive network in place.

And clearly, there needs to be more sources of funding, whether it’s the state, private insurance or employers. There has to be an increase in funding for these issues so those who provide this type of care can be compensated for it.

I can tell you that my perspective as a finance executive is not what it used to be. Today, I tend to intervene when people start talking about reductions in their behavioral health programs. Instead of hitting the “easy button,” I believe we’re going to have to do the hard work of figuring out how we reduce losses.

The good thing is, I’m finding I have colleagues of like mind who are committed to doing the same – the right thing.

Picture: Benjavisa, Getty Images


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Eddie Soler

Eddie Soler is senior executive officer and chief finance officer for AdventHealth’s Multi-State Division, Behavioral Health Steering Committee member and conference presenter.

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