Behavioral health care shortfall called out as demand soars

  • Mark Keroack, president and CEO of Baystate Health, speaks at the groundbreaking event for the Baystate Behavioral Health Hospital in Holyoke last March. GAZETTE FILE PHOTO

For the Gazette
Published: 12/8/2022 7:20:42 PM
Modified: 12/8/2022 7:20:22 PM

BOSTON — The COVID pandemic exacerbated a behavioral health crisis, particularly in western Massachusetts, highlighting an urgent need for accessible community services, lawmakers and western Massachusetts behavioral health care leaders agreed during a recent virtual forum.

“The roadmap to behavioral health is about finding the doorway and getting through that doorway for a medical assessment and urgent access to behavioral health care,” said Health and Human Services Secretary Marylou Sudders at the Massachusetts Health Policy Forum sponsored by the Heller School at Brandeis University. “It is about that front door so that emergency rooms will not be the only pathway for so many.”

The 2020 statewide COVID-19 Community Impact Survey found that the lack of access to mental health and substance abuse treatment has significantly impacted individuals and families throughout western Massachusetts.

Mark Keroack, president and CEO of Baystate Health, said that some of the region’s unique public health challenges are often linked to transportation issues, a lack of economic opportunities and internet access.

“The idea that social stressors promote or unmask behavioral health problems is not new. While the incidence of some behavioral health conditions like schizophrenia stays within narrow ranges across geographies and over time, others like depression, anxiety, post-traumatic stress disorder, or autism vary widely,” Keroack said. “The burden of behavioral health problems is inextricably intertwined with social issues including housing insecurity, food insecurity, legal challenges and substance use disorder.”

‘Roadmap’ is helping

Keroack explained that behavioral health has historically been the “poor stepchild” in the medical family, and chronic underfunding has plagued this field for generations. However, the recent “roadmap for behavioral health state reform” that Gov. Charlie Baker announced in 2021 has helped behavioral health professionals emphasize issues at the forefront of their field.

“We now better appreciate that money invested in behavioral health help control overall health costs by improving adherence to care plans and healthy lifestyles,” Keroack said. “Understanding these linkages has led Baystate Health to embed behavioral health providers in all our primary and specialty practices to catch problems earlier and coordinate care across specialties. It also led to plans to expand our inpatient hospital capabilities.”

Behavioral health patients in western Massachusetts experience a scarcity of community resources that leaves them at risk of their conditions worsening, which in turn can dramatically increase the demand for inpatient care.

Steven Winn, president and CEO of Behavioral Health Network, said that at times, the number of mental health beds necessary for in-facility treatment easily swells into the 50s and 60s.

While lawmakers are working to implement reforms, Winn said staffing shortages gradually complicate many health providers’ emergency department crises.

Behavioral Health Network currently operates 11 outpatient clinics in western Massachusetts where people can walk in and get treatment for a mental health or substance use problem. However, the lack of funding for hiring and retaining staff has traditionally caused challenges.

“The thing we are most excited about is having the resources come into the community behavioral health centers that will allow us to offer decent wages to people and hopefully reduce the turnover,” said Winn. “Turnover results in waitlists, and that sort of follows on down the road. When people can’t get into the care they need in the community, their needs become more acute, and that’s when they end up in the emergency departments needing more intensive care.”

Demand rises

The COVID-19 pandemic and the telehealth option encouraged more people in the region to seek behavioral health services. According to the Blue Cross Blue Shield of Massachusetts Foundation’s latest statistics, the insurer reported 8 million in-person and virtual behavioral health visits in the third quarter of this year, up from 4 million in 2019. As a result, demand for qualified professionals is expected to grow.

State educational loan repayment applications under a $130 million program Baker’s administration announced in November will open this month. Social workers, physicians, nurses, psychiatrists, substance use recovery coaches, and others working in community health centers will be able to apply and seek funding between $12,500 and $300,000.

Behavioral health care leaders said the loan repayment program means that the state acknowledges its role in fostering a healthy behavioral health infrastructure, and this will significantly impact the job market.

“It will definitely help, especially with retention and the recruitment efforts,” said Tania Barber, president and CEO of Caring Health Center in Springfield. “I think it’s an excellent opportunity that is certainly going to help move the needle further than where we’ve been.”

Nino Mtchedlishvili writes for the Gazette as a member of the Boston University Statehouse Program.
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