The Impact of Front-Line Primary Care In Improving Access For Mental Health Outcomes

By Ed Cladera, MD, medical director, AristaMD

Over the past few years, there have been encouraging improvements in the realm of mental health care in the United States. Initiatives to improve mental health outcomes, such as the Affordable Care Act (2010), have been primarily aimed at requiring increased insurance coverage to encompass mental health services at levels comparable with physical medical care.

Despite these improvements, such policies do not address issues caused by access challenges within the referral system, and many of the one in five adults suffering from mental illness in the United States still are not accessing the mental health care they require and need. In particular, there exists a shortage of mental health providers across the country, and these health professionals are likely to be out-of-network for many patients. Further barriers preventing patients from obtaining care include travel, missed work time associated with appointments, and the social stigma of seeking mental health care.

Faced with these challenges, patients with mental health issues are resorting to emergency departments in search of mental health services. Hospital emergency departments lack access to psychiatric services and mental health resources. Further, as patients are improperly treated in urgent care settings, this can lead to reduced access to care for those with acute medical issues, which then results in poorer overall outcomes at the highest cost of care.

To address these multi-faceted challenges, value-based care models have placed particular importance on the role of primary care, as these organizations are uniquely positioned to promote innovation and efficiency through proactive and coordinated care. When it comes to mental health services, primary care providers (PCPs) serve at the front line of care and are positioned to be an excellent means of providing access to mental health care to a patient population in need. However, many PCPs lack adequate resources to treat these often complex and specialized issues.

Telehealth technologies, such as telepsychiatry and eConsults, can support primary care practices by creating networks to provide timely, documented, and standardized access to mental health professionals. This equips PCPs to more effectively manage patients with mental health concerns, reducing wait times and improving mental health outcomes.

AristaMD’s eConsult platform connects PCPs with adult and pediatric psychiatry, addiction medicine, and behavioral health specialists to provide care planning support and treatment recommendations. Ninety-one percent of AristaMD’s mental and behavioral health eConsults have been shown to include medication regimen guidance including initiation of treatments, diagnostic recommendations, and medication dosage adjustment, all of which can be managed within the primary care setting with the support of specialty insight.

The ability to receive these critical mental health care treatments within a primary care setting positively impacts outcomes and financial bottom lines for payors and health systems alike by maximizing health care resources. This frees queues for mental health providers to see higher acuity patients in need of face-to-face appointments and provides lower acuity patients necessary care within the comfort of their primary care office.

In conclusion

The status of mental health treatment within the United States has improved over the years, but it still has much farther to go in improving outcomes for those suffering from mental illnesses. While access has been improved, more innovative models and solutions must be explored and implemented if mental health parity is to become a reality.

Given the role of primary care in providing front-line access to proactive and necessary mental health care, telehealth technology supporting PCPs provides a clear avenue toward improving mental health outcomes, ultimately creating a brighter future for those in need of treatment for mental illnesses.

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