There is little doubt that Olympians are under tremendous pressure to deliver in Tokyo this month. And while all eyes are on Olympic champion Simone Biles and her decision to pull out of the women’s gymnastics team final and individual all-around competitions, BPC is reminded by her choice of how important it is to act on integrating mental health and primary care.
In BPC’s March 2021 report, Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration, our Behavioral Health Integration Task Force outlined a comprehensive set of policy recommendations to achieve this goal. The recommendations are based on a model that is already demonstrating evidence of improved outcomes and cost effectiveness: integrating mental health and substance use care with primary care.
While research has documented the link between physical and mental health, it is hard for many of us to imagine that those in peak physical health can and do suffer from mental health challenges. This is likely part of the enduring stigma around mental health issues that deters many elite athletes from seeking help. However, BPC believes this only serves to bolster our claim for the need for behavioral health and integration for the rest of us: 51.1 million Americans suffer from mental health issues during any given year, with many more likely not reporting their challenges to health care providers. This is a need that has only grown during the COVID-19 pandemic, and one which has likely been intensified by new research indicating individuals with mental health disorders are at greater risk of mortality from COVID-19.
An important step toward integration is expanding the workforce and increasing primary care provider capacity. The goal here is to provide primary care providers with supports that would enable them to improve mental health screenings, deliver more treatment for mild to moderate conditions, and coordinate care for patients who need specialized services. While nearly 40% of people who receive behavioral health care already get it through their primary care provider, many of those providers just don’t have the training, financial resources, guidance, and staff to deliver integrated care.
In order to successfully integrate care, BPC’s task force recommended defining for payers a set of baseline service standards and performance metrics informed by a wide array of stakeholders. This will ensure access to quality care is equitable across geographic regions and among people who are underserved. These standards can be used to build upon existing payment models to drive large-volume integration in Medicaid, as well as incorporated into financial incentives within Medicare and Medicare Advantage for individual providers. Some states have already tackled this issue through Medicaid Managed Care Organizations, with results indicating both cost savings and better health outcomes for their patients.
Simone Biles isn’t the first Olympic athlete to draw attention to mental health concerns, and we can’t imagine she’ll be the last. But for now, we know one thing is true: she has snagged a win better than Gold in expanding the discussion around the importance of prioritizing mental health care. Now is the time for policymakers to seize this moment and help improve the health outcomes for all Americans by integrating mental health and substance use care with primary care.