National Council Magazine - Winter 2009 - 2

Editorial Together We Will Save and Improve Lives Linda Rosenberg, MSW, President & CEO, National Council for Community Behavioral Healthcare f someone told you they had access to specialty cardiology treatment but not to primary care, you’d ﬁnd it ironic. If someone told you they are being treated for their cancer but not for their co-occurring diabetes, it would seem ridiculous. Yet that is exactly what we’ve done to persons with serious mental illness. The National Association of State Mental Health Program Directors 2007 study Morbidity and Mortality in People with Serious Mental Illness, which revealed that, on average, people with severe mental illness die 25 years earlier than the general population, was a bombshell. But the tragic report ﬁndings corroborated what those in the trenches — community behavioral healthcare providers — suspected, we’re helping people recover from mental illness when their lives are endangered due to neglect of other serious health issues. The barriers to complete care seem daunting. A National Council survey of community behavioral organizations revealed that although over 90% consider general healthcare for consumers a priority, only one in two organizations has any general healthcare capacity, and less than one in three has the capacity to provide the services onsite. The most common barriers to obtaining general medical services are problems in reimbursement, workforce limitations, physical plant constraints, and lack of community referral options. The National Council’s report, “The Person-Centered Healthcare Home,” featuring an overview of evidence-based approaches makes a strong case — to policymakers, planners, and providers of general healthcare and behavioral health services — for creating a patient-centered healthcare home for people with serious mental illnesses either by creating general healthcare capacity within the behavioral health care organization or through a seamless collaborative relationship with a primary care provider. We also cannot ignore the large unmet need for mental health and substance abuse specialty services within general healthcare. A 2007 Health Affairs article notes that community health centers reported that over 40% of uninsured patients and 20% of Medicaid patients had difﬁculty accessing mental health services; and over 50% of uninsured patients and 30% of Medicaid patients were challenged in accessing substance abuse treatment. Primary care needs the staff and skills to assess behavioral health conditions; and behavioral health care providers need the capacity to accept and treat the complex cases referred to them from primary care. There are community behavioral health organizations that have implemented innovative clinical and ﬁnancing models that make possible the provision of comprehensive care in collaboration with primary care centers. As you will see in the range of model programs showcased in this issue of National Council Magazine, collaboration is evident in colocated mental health and primary care services, enhanced referral processes between mental health and primary 2 / NATIONAL COUNCIL MAGAZINE • WINTER 2009 I care, sharing of patient information, and cross-training of staff. We’re proud of our members’ work and applaud their commitment. The National Council’s job is to help our member organizations do their jobs — saving and improving lives. We’ve played a leading role in advocating for policies that break down barriers to integration and collaboration, developing clinical and business models that support seamless and comprehensive healthcare, and fostering collaborative opportunities. Advocating for funds to bring primary care services to behavioral health organizations has been a National Council legislative priority. And last week, we achieved a small but signiﬁcant legislative victory when the 111th Congress authorized one of the key provisions in the Community Mental Health Services Act championed by the National Council — a new $7 million grant program, housed at the Substance Abuse and Mental Health Services Administration, giving people with serious mental illnesses the promise of a healthcare home. In addition to our legislative activity, we’ve been active on the practice improvement front. The National Council Four Quadrant Model is widely used to guide collaborative efforts across the country. Our Primary Care-Behavioral Health Collaborative project —currently in its third phase — has provided a wealth of guidance and hands-on training, helping member organizations and their primary care partners to overcome clinical, cultural, and communication
National Council Magazine - Winter 2009

Table of Contents for the Digital Edition of National Council Magazine - Winter 2009
