Behavioral Health Integration News

Pennsylvania Governor Josh Shapiro has signed an Executive Order to establish a Behavioral Health Council aimed at enhancing the accessibility and quality of mental health and substance use disorder (SUD) services across the state. This council will develop an action plan to address gaps in access, affordability, and service delivery, working to eliminate barriers between state agencies, healthcare providers, and more, with the goal of reducing wait times for services. The Council will focus on innovative care models, workforce issues, social equity, and collaboration across various sectors. It will include 33 members representing a wide range of stakeholders and work to create a more holistic healthcare system in Pennsylvania. The Executive Order also establishes an Advisory Committee to support the Council’s efforts. This initiative aligns with the Governor’s commitment to improving mental health services, with increased investments in county mental health programs and school resources. The Council’s creation was influenced by various recommendations from different stakeholder groups.

A recent news article in the Arkansas Democrat Gazette reports on the emergence and increase in xylazine across the Arkansas drug supply. Xylazine is a non-opioid sedative or tranquilizer approved for use only in animals, and it is increasingly showing up in illicit drugs such as fentanyl, heroin and cocaine. n humans, the side effects encompass sedation, impaired respiration, perilously low blood pressure, decreased heart rate, and an elevated likelihood of fatal overdose. Additionally, there is a potential side effect of rapidly deteriorating skin ulcerations, which, if left untreated, may necessitate amputation.   “The dangers of xylazine and the rapid rise in illicit use of the drug prompted the Biden administration to designate the drug as an emerging drug threat in April and to issue a national response plan in July to address the threat. Among other things, the response plan calls for standardized forensic testing practices, development of rapid clinical tests and development and deployment of a test to detect xylazine in drug samples at all levels in the supply chain, from wholesale seizure quantities to retail levels within communities.”

The co-founders of ABHIN – Patty Gibson, MD and Kim Shuler, LCSW – recently served on an advisory panel of national subject matter experts working at the forefront of Behavioral Health Integration.  The work of the Network for Excellence in Health Innovation (NEHI) Advisory Group is summarized in a newly released report entitled Scaling Behavioral Health Intervention in Primary Care: Wading through the Complexity to Tackle a Decades-Old Challenge. The report examines the current state of BHI and provides a comprehensive look at the evolution of approaches and initiatives. It includes a call for flexibility and greater collaboration between providers and payers to approach expansion more urgently. “Calling the mental health situation in this country a crisis is a start, but that must translate to a sense of urgency that boosts coordinated activities.”

The Primary Care Collaborative’s March 2023 report Primary Care and Behavioral Health: Just the Facts provides some of the latest figures on prevalence, inequities, and cost related to mental illness. It provides compelling evidence that integration of primary care and behavioral health care is key to addressing the crisis we are facing. “There is no path forward that does not include integrating behavioral health into primary care. Primary care is where most people get medications and where people expect to be treated, and we have evidence-based practices that work.”

The largest law enforcement agency in America has a suicide problem. Over the past 15 years, U.S. Customs and Border Protection has lost 146 employees to suicide. Senior officials became especially concerned this year because deaths spiked early on. “We were sitting at five suicides, and that was alarming,” said acting CBP COO Benjamine “Carry” Huffman in an exclusive interview with the Washington Examiner.

The Biden administration laid out a road map (PDF) for increasing pay parity and access to mental health care as efforts in Congress stall out. The Department of Health and Human Services (HHS) released the road map Friday that laid out strategies for integrating mental health and substance abuse care into larger systems. A key pillar of the road map is to make it easier for people to get care, including making reforms to behavioral health financing arrangements in government programs such as Medicaid.

In the science-to-medicine pipeline, there is a point when a body of evidence is so well-established that to not put the science into action would be an abdication of responsibility. When it comes to the current crisis, there are at least five things that science has shown conclusively to be effective, where communities and healthcare providers can apply what we already know works. 

Did you know that there are over 80 randomized control trials that show behavioral health integration improves mental health outcomes and medical comorbidity outcomes as well? A new report published by the American Medical Association and Manatt Health presents some excellent – and motivating – information! The report outlines the opportunities and challenges of incorporating virtual care (telehealth) and other digital tools to accelerate the adoption of behavioral health integration. A June 21st webinar brought together several experts to discuss the report and how BHI is the best path to our urgent goal of improved mental and physical health outcomes. Excitement about BHI grows faster as the evidence becomes more and more clear: BHI will save lives and presents a practical, effective way to address the mental health crisis.

In collaboration with the Arkansas Department of Health, Division of Aging, Adult, and Behavioral Health Services, The University of Central Arkansas is implementing the Collegiate Naloxobox Bystander Program.  The Naloxobox provides lifesaving Naloxone for emergency situations involving overdose due to opioids. The Naloxboxes will be mounted on walls in areas on campus where a student may experience an overdose, like emergency defibrillators and fire extinguishers. Each Naloxbox holds two doses of Naloxone, a mask for rescue breathing, gloves, and information on how to obtain personal Naloxone and how to access addiction treatment.  We look forward to seeing more colleges, healthcare, and other facilities implement this type of lifesaving program.

The leaders behind whole health medical school in Bentonville not only want to expand health care in northwest Arkansas, but they also want to remake how it’s done. The 154,000-SF Alice L. Walton School of Medicine, the brainchild of the Walmart Inc. heiress,  is scheduled to break ground this spring near the Crystal Bridges Museum of American Art.

There literally aren’t enough hours in a single day for primary care physicians (PCPs) to provide the full gamut of basic, guideline-based care, according to a simulation study. PCPs would need an “infeasible” 26.7 hours each day to provide preventive, chronic disease, and acute care for a typical panel of U.S. adult patients, Justin Porter, MD, of the University of Chicago, and colleagues, reported in the Journal of General Internal Medicine.

The opioid and illicit drug epidemic began with misleading marketing and overprescribing of opioids in the 1990s, eventually leading to Arkansas having the second-highest opioid prescription rate in the nation today. The flood of opioids and subsequent addiction led to an influx of heroin and now synthetic opioids, particularly those involving the synthetic opioid fentanyl, which is frequently illicitly mixed with many street drugs and used in counterfeit prescription pills.

This paper presents the Comprehensive Healthcare Integration (CHI) Framework, a new framework for guiding the implementation of integration of physical health (PH) and behavioral health (BH) (mental health and substance use conditions), that can help providers, payers, and population managers to measure progress in organizing delivery of integrated services – referred to in this report as “integratedness” – demonstrate the value produced by progress in integrated service delivery and provide initial and sustainable financing for integration. Integration, as used herein, is also inclusive of attention to social determinants of health (SDOH) and health equity for underserved populations.

Recognizing the strong connection between physical and behavioral health, the Bipartisan Policy Center convened the Behavioral Health Integration Task Force. The Task Force focused on breaking down barriers to integrating primary and behavioral health care. Their white paper and a full set of recommendations titled, Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration can be viewed here.