Mental health care is costing us a fortune.
Financially and personally.
Sit back and ruminate on your life. I’m sure you or someone you’re close to struggles with some level of mental illness. The matters of the mind have challenged and tested the health care system in a great many ways.
Mental health care in the United States has been stretched thin. It seems like there aren’t enough resources to meet the need. Patients often over-utilize emergency rooms when they are in mental health crises. In times of suicidality, an emergency room isn’t the worst place to be, but given emergency medicine has exponentially ramped up since the pandemic, their resources are usually stretched just as thin. Primary care providers may not be equipped to handle mental health crises and often cannot fit the visit into their schedule at such short notice.
Perhaps there is another answer: psychiatric urgent cares. Urgent care clinics that have the central purpose of triaging and treating behavioral health crises. They present a compelling solution.
In a discussion during a virtual seminar called Payment and Policy Solutions for America’s Mental Health Care Crisis, a panel of clinicians talked about the challenges this country faces with mental health. Rachel Werner, MD PhD stated, “There aren’t enough providers to meet the existing needs and to ensure equitable access to treatment. Over 75% of U.S. counties don’t have a prescriber and wait times for treatment can range from weeks to months…”. To most in healthcare, this statement doesn’t come with much shock. But it begs the question, what is the solution?
As Dr. Werner said, access is a major problem in the behavioral health world. Mental health crises can escalate quickly and often, time is of the essence. Without reliable access to mental health care, any progress patients have with their trajectory of care can unravel. If a patient’s only accessible mental health care is the emergency room, that is what they will use because, simply put, they have no other option. This can lead to increased emergency room wait times and over-utilization of emergency medicine resources.
Of the Medicare population, about 25% of people experience challenges with behavioral health. And of the Medicaid population, about 40% of people report mental illness (Centers for Medicare and Medicaid Services, 2024). Patients must be at a certain income or age threshold to qualify for these programs. So, it begs the question, if patients are already stretched thin financially, how are they going to pay for the high out-of-pocket costs of psychiatric health care? It’s difficult which explains the challenges with access to appropriate and timely psychiatric care.
The state of Indiana recently took a magnifying glass to the state of their psychiatric care delivery system and its financial ramifications. They found that “...total economic burden of untreated mental illness for Indiana was estimated to be $4.2 billion annually.” (Taylor et al., 2023) This number, while seemingly shocking, didn’t come as a surprise to most in the healthcare space. The researchers in this study noted that the social and financial consequences of untreated mental health are large and should not be ignored. They reference the need for better access to psychiatric care that expands beyond the typical emergency room. A strong psychiatric urgent care network could help bridge the gap in access. By making providers available in the clinic setting, patients would not only have a place to go to alleviate a mental health crisis, but a place to establish continuity of care and follow up.
What do Psychiatric Urgent Cares Do?
The fact that psychiatric urgent cares exist is news to many people. So what exactly can they treat? What types of actions do they take? Let’s take a look. I compiled some information based on the psychiatric urgent care centers in the region where I live.1. They are available 24 x 7.
Most psychiatric urgent care centers have a crisis line that is available to patients or their families. These phone lines are used to triage and assist anyone experiencing a mental health crisis.
2. They will go where the crisis is happening if the patient cannot come to the center.
This includes homes, community centers, schools, etc.
3. They do not deny care based on financial status. They have funding available to assist with
patients who are experiencing crises but cannot afford treatment.
Do Psychiatric Urgent Cares Actually Work?
By the data available, it would appear that Behavioral Health Urgent Care Centers work fairly well. They have helped in increasing access to behavioral health and reducing poor utilization of resources like overuse of the emergency room. There isn’t necessarily a lack of these types of centers, though. Many community health centers offer urgent mental health care to their established patients. Essentially, “sick visits” for behavioral health. The only issue is, more data is needed (Cone Health, 2023).
As the demand for better, more affordable access to behavioral health care grows, hopefully the number of psychiatric urgent cares will follow suit.
Sources:
Centers for Medicare and Medicaid Services. (2024, January). CMS Announces New Model to Advance Integration in Behavioral Health. CMS.gov. https://www.cms.gov/newsroom/press-releases/cms-announces-new-model-advance-integration-behavioral-health
Cone Health. (2023). Behavioral Health Crisis Center Reduces ED Visits, Shrinks Health Disparities. www.aha.org.
Dupuy, M.D., J., Huskamp, M.D., H., Ja, LCSW, MPH, M., Pham, M.D., H., & Werner, M.D., R. M. (2022). Payment and policy solutions for america’s mental health care crisis. Penn LDI. https://ldi.upenn.edu/events/payment-and-policy-solutions-for-americas-mental-health-care-crisis/
Taylor, H. L., Menachemi, N., Gilbert, A., Chaudhary, J., & Blackburn, J. (2023). Economic burden associated with untreated mental illness in Indiana. JAMA Health Forum, 4(10). https://doi.org/10.1001/jamahealthforum.2023.3535 Assessed and Endorsed by the MedReport Medical Review Board