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Behavioral Health: Can Primary Care Help Meet the Growing Need?

Friday, May 04, 2012

An estimated one out of five adults in the U.S. suffers with mental illness. Some 11 million adults reported an unmet need for mental health care in the past year, a situation no doubt made worse by the recent recession and higher-than-normal unemployment.

The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. For example, the expansion of Medicaid holds the potential to provide treatment to millions with substance use or mental health disorders who might not otherwise have gotten this care.

But Medicaid already finances more than half of mental health care in the U.S. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity to meet the demands of increased enrollment? Will sacrifices in other benefits and services be needed in order to provide mental health parity? Will the health professional workforce be large enough to serve those in need of care? Are innovative programs that integrate behavioral and physical health showing promise, and if so, can they be scaled up in time to meet the need? What role will health information technology play and will privacy issues be a barrier to its use in mental health care?

To address these questions and more, the Alliance for Health Reform and the Centene Corporation sponsored a May 4 briefing. Speakers were: John O’Brien, of the Disabled and Elderly Health Programs Group in the Center for Medicaid, CHIP, and Survey & Certification at the CMS; Joseph Parks, Missouri Department of Mental Health; Gloria Wilder, Core Health, which assists organizations and providers in helping underserved populations; and Sam Donaldson, president and CEO of Cenpatico, an accredited managed behavioral health care organization active in 10 states. Ed Howard and Deanna Okrent of the Alliance co-moderated.


 Deanna Okrent, Alliance for Health Reform, Moderator
 John O’Brien, Centers for Medicare and Medicaid Services, Speaker
 Joseph Parks, Missouri Department of Mental Health, Speaker
 Sam Donaldson, Cenpatico, Speaker
 Gloria Wilder, Core Health, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Behavioral Health: Can Primary Care Help Meet the Growing Need? (Adobe Acrobat PDF), 5/4/2012
Full Webcast/Podcast: Behavioral Health: Can Primary Care Help Meet the Growing Need?

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

John O'Brien's Presentation (Adobe Acrobat PDF), 5/4/2012
Deanna Okrent's Presentation (PowerPoint), 5/4/2012
Sam Donaldson's Presentation (PowerPoint), 5/4/2012
Joseph Parks's Presentation (PowerPoint), 5/4/2012

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Speaker Biographies (Adobe Acrobat PDF), , 5/4/2012
Agenda (Adobe Acrobat PDF), updated May 3 by the Alliance for Health Reform, 5/3/2012
Source List (Adobe Acrobat PDF), , 5/4/2012
Material's List (Adobe Acrobat PDF), , 5/4/2012

Offsite Materials (briefing documents saved on other websites)

Adults Experiencing Mental Illness Have Higher Rates of Certain Chronic Physical Illness, Substance Abuse and Mental Health Services Administration, 4/10/2012
Moving Beyond Parity – Mental Health and Addiction Care under the ACA, New England Journal of Medicine, 9/15/2011
- Barry, Colleen, and Haiden Huskamp
Veterans Dept. Will Increase Mental Health Staffing, New York Times, 4/12/2012
- Dao, James
Mental Health and Medicaid Costs: Why Ignoring Mental Health is Expensive, Huffington Post, 2/22/2011
- Friedman, Michael
Mental Health Financing in the United States, A Primer (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 4/1/2011
- Garfield, Rachel
Managed Care, Medicaid and Mental Health, National Alliance on Mental Illness, 3/23/2011
Seizing Opportunities Under the Affordable Care Act for Transforming the Mental and Behavioral Health System, Health Affairs , 2/1/2012
- Mechanic, David
Medicaid Policy Options for Meeting the Needs of Adults with Mental Illness under the Affordable Care Act, Kaiser Commission on Medicaid and the Uninsured, 4/1/2011
Mental Health Parity and Mandated Coverage of Mental Health and Substance Use Disorder Services After the ACA, Congressional Research Service, 1/5/2012
- Sarata, Amanda
Medicaid Changes Being Felt in Local Mental-Health Community, The Athens News, 1/25/2012
- Stark, Stephanie
A Tale of Two Systems: A look at State Efforts to Integrate Primary Care and behavioral Health in Safety Net Settings (Adobe Acrobat PDF),National Academy for State Health Policy, 5/10/2010
- Takach, Mary, Kitty Purington, Elizabeth Osius
The NSDUH Report: Physical Health Conditions among Adults with Mental Illnesses, Center for Behavioral Health Statistics & Quality, Substance Abuse and Mental Health Services Administration, 4/5/2012
Tribal Substance Abuse Treatment Facilities Lead in Offering Community Outreach Services, Substance Abuse and Mental Health Services Administration, 4/10/2012
State Behavioral Health Agencies and the Affordable Care Act, George Washington University Department of Public Health, 5/9/2011
- Barret, Nick, et al
Bringing Behavioral Health into the Care Continuum: Opportunities to Improve Quality, Costs and Outcomes, American Hospital Association - Trendwatch, 1/1/2012
The Looming Expansion and Transformation of Public Substance Abuse Treatment under the Affordable Care Act, Health Affairs, 8/1/2011
- Buck, Jeffrey
Evolving Models of Behavioral Health Integration in Primary Care (Adobe Acrobat PDF),Milbank Memorial Fund, 3/1/2012
- Collins, Chris, et al
Integrating Mental Health and Addiction Services for Vulnerable Families, Robert Wood Johnson Foundation, 3/29/2010
Projections of National Expenditures for Mental Health Services and Substance Abuse Treatment 2004 – 2014, Substance Abuse and Mental Health Services Administration, 11/1/2008
- Levit, Katharine, et al
Medicaid Emergency Psychiatric Demonstration, Center for Medicare and Medicaid Innovation, 3/1/2012
Pioneering Integrated Mental and Medical Health Care in Community Mental Health Centers, Commonwealth Fund, 1/1/2011
Medicaid and Mental Health Services, National Health Policy Forum, 10/23/2008
- Shirk, Cynthia
State Mental Health Cuts: A National Crisis, National Alliance on Mental Illness, 3/1/2011
State Mental Health Cuts: The Continuing Crisis, National Alliance for Mental Illness, 11/1/2011
How to Bring Sanity to Our Mental Health System (Adobe Acrobat PDF),Heritage Foundation, 12/19/2011
- Torrey, E. Fuller
Unemployment and Mental Health, Institute for Work and Health, 8/1/2009
Reclaiming Lost Decades: The Role of State Behavioral Health Agencies in Accelerating the Integration of Behavioral Healthcare and Primary Care... Full Report (Adobe Acrobat PDF),, 5/1/2012
Reclaiming Lost Decades: The Role of State Behavioral Health Agencies in Accelerating the Integration of Behavioral Healthcare and Primary Care... Report Overview (Adobe Acrobat PDF),, 5/1/2012


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