Among the frequent visitors to our overburdened emergency departments are individuals with behavioral health issues. That’s common knowledge. But I was surprised to learn during a recent webcast hosted by the American Hospital Association that one out of every four hospital admissions involves a patient with some sort of psychiatric or substance abuse disorder.
For those two reasons alone, it makes practical sense for health care providers and their partners across the care and social continuum to find better ways to identify vulnerable people in their communities and craft a more sensible, long-term strategy to address their problems, including the non-health factors.
“We need to move away from a crisis-driven system to one that focuses on public health, prevention and early intervention. That’s more effective than a singular focus on treatment,” said Melba J.T. Vasquez, past president of the American Psychological Association and the featured speaker on the webcast.
Two things stand in the way of realizing the goals Vasquez described. For one thing, behavioral health has always been less of a priority in our care system than physical health. Misunderstandings and myths about those with psychiatric or substance abuse issues stymie strategies to improve how we address their needs, and insufficient funding has been a chronic problem. Provisions in the Affordable Care Act, which recognizes the value of treating the whole person, may help.
The second challenge is equally onerous: disparities in care for members of racial or ethnic minorities. For certain segments of your community, there may be a cultural stigma attached to seeking psychiatric care. Access may be a problem because of a dearth of local behavioral health professionals. Transportation issues may discourage patients from seeking help.
Then there’s the unconscious bias that all of us have when it comes to people who are different from ourselves. Even the most well-meaning folks perpetuate certain stereotypes in their own minds about certain racial and ethnic groups — including, Vasquez said, behavioral health practitioners who themselves are members of minority groups. That affects how we relate and react to them. Health professionals, and all of us, for that matter, must become more aware of our unconscious biases in order to overcome them.
Moreover, behavioral health care providers must understand the linguistic nuances, tone of voice, facial expressions and body language that could be perceived negatively by a patient with a different cultural background and that keep them from making follow-up appointments.
“The average number of [behavioral health care] sessions for racial or ethnic minorities is one,” Vasquez noted starkly.
As you struggle to manage population health, to improve wellness in your community and reduce unnecessary admissions and emergency department visits, behavioral health care must move up your priority list. This webcast is valuable as a primer on the issues you face and how you can begin to address them. I encourage you to listen in by clicking here.
