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Massachusetts still struggles to provide access to mental health care and addiction treatment, according to a new report by the Blue Cross Blue Shield Foundation.
The report follows a December survey of more than 2,000 Massachusetts adults, which found that more than half of respondents reported difficulty accessing behavioral health care services last year. Many of the people surveyed said this led them to abandon their search for treatment.
The authors of the new report outline several recommendations for revamping mental health care and substance abuse treatment in the state, and say they hope this will serve as a call to action for policymakers.
Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation, spoke with WBUR's Bob Oakes about the report and the recommendations. Here are some highlights from that interview.
What are the most glaring problems for people trying to access mental health care and treatment for substance abuse in the state?
The No. 1 issue is just people getting into the system. When you're initially trying to get an appointment with the provider, you often have to wait a very, very long time. Another very different but related issue is major challenges in terms of workforce. There are a lot of programs where we just don't have enough staff.
How does the workforce shortage impact patients?
When people go to the emergency department for a mental health or substance use disorder issue and they need to be transferred to a bed, sometimes there isn't a physical bed available. But often times, there are beds. There just aren't enough people, enough staff. Another challenge is that there are many psychiatrists in particular but all types of providers who don't accept insurance.
Fifty-four percent of Massachusetts youth who experienced a major depressive episode received no mental health services in the year that the report covers. It's so frightening when you think about the potential for youth suicide.
It's a really appalling statistic. It's one of the reasons that we really focus on getting them into treatment. Primary care doctors and other clinicians should also be trained and paid for screening for mental health and substance use disorder conditions so they can help identify kids, adolescents or adults who need help and refer them to treatment.
Who needs to get involved to help accomplish these goals of making mental health care more accessible?
The recommendation for behavioral health reform is really going to require a broad group of stakeholders to work on these issues. The problems are very complex. They are not just with the MassHealth program (Massachusetts' Medicaid and children's health insurance program) or in the public sector. They are with the private sector as well.
So our foundation believes we need to address this problem in a similar way that we approached the issue of health care coverage and costs. We need private sector and public sector advocates, providers, payers, public and private employers to really flesh out what the issues are that we need to address here. How would we implement the recommendations? Because everybody's got a stake in this.
The plan is called "A Call to Action." Do you think that state lawmakers and private businesses are ready to move on this?
I think the time is now. We have a really solid understanding of the problems. We're providing a framework for addressing those problems with a set of solutions. There may be other recommendations that people would present. I do think that people are beginning to recognize that we wouldn't accept the types of challenges that we experience in getting mental health or substance use disorder care when getting medical care. So I think that we have reached a tipping point of saying, "This is not acceptable."
In addition to the recommendations discussed above, the report recommends:
- providing comprehensive, "whole-person" care;
- addressing workforce shortages by better attracting and retaining health care professionals;
- streamlining state regulations and requirements for more efficient health care oversight;
- and establishing a "Behavioral Health Reform Team" to develop a plan to help enact these reforms.
This segment aired on January 31, 2019.
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