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Olivia Hugentobler

Behavioral Health: Past, Present, and Future

Over our last 20+ years in the Behavioral Health industry, the landscape of the sector has changed dramatically. We have observed as trends have come and gone, care has improved, and organizations have developed to meet the needs of their clients better. Data and analytics have grown in importance as a role in patient care and efficiency. For those within this sector, understanding the industry's past, present, and future trends is crucial.


According to 2022 Adult Prevalence of Mental Illness (AMI) data, nearly 20 percent of US citizens suffer from mental health disorders, which continues to grow. With the need for higher cognitive and behavioral health resources, understanding past, present, and future trends/concepts can help us unlock the key to increased access, better outcomes, and improved treatment options.


As we near the end of 2022, we find ourselves looking back at the past two decades of the behavioral health sector and toward the future. How did we get here, and where are we headed?



Past


It may seem odd to analyze past trends in the behavioral health sector, but understanding the past helps us understand the present and better prepare for the future. You may remember some of these trends if you’ve been in the industry for a while.


Development of The Recovery Model


The hallmark principle of the recovery model is the belief that people can recover from mental illness to lead full, satisfying lives. Until the mid-1970s, many practitioners believed that patients with mental health conditions were doomed to live with their illness forever and would not be able to contribute to society.


This belief particularly affected people with schizophrenia, schizoaffective disorder, and bipolar disorder. However, several long-term studies from several countries published in the mid-70s showed this to be false.

However, it still took time to change the system once this evidence emerged. By 2003, individuals advocating for recovery-based care found their work paying off. A mental health commission appointed by President George W. Bush gave the final report of its work and made recovery-based care a national priority. This final report was ambitious. It envisioned a future that focused on the prevention, early detection, and cure of mental illness.


Today, the concept of the recovery model is familiar to most mental health practitioners, but individuals are still working out how to design programs and treatments based on these principles.


Full Institutionalization


With the advent of revolutionary pharmacologic related to mental health care, the US model of broad institutionalization decreased from the 70s onward. With these advanced medications, patients could lead productive lives while maintaining a more typical non-institutional home and work life.


These groundbreaking pharmaceuticals continue to play a significant role in behavioral health treatment and benefit millions of patients worldwide.




Present


As we continue to work in the behavioral health field, these current trends significantly impact the industry and will undoubtedly continue to shape the landscape.


Increased Reliance on Data


With healthcare organizations increasingly aiming to provide patients with comprehensive, holistic care, big data and analytics tools have become essential in the medical field. These solutions are equally as crucial for those in the mental and behavioral healthcare industry.


Leaders at California’s Mental Health Services Oversight and Accountability Commission (MHSOAC) recognized the need for advanced analytics solutions to enhance care delivery. The organization partnered with leaders in the field to help gather insights from multiple data sources, leading to improved mental health services.


“We have really enhanced our analytics capabilities in the last few years. Some of our main goals center around what we call the seven negative outcomes, which include reducing criminal justice involvement, unemployment, school failure, suicide, homelessness, and prolonged suffering. This has been our approach for tapping into the types of data that are available at the state level that we maybe have not tapped into previously.” said Dawnte R. Early, Ph.D., MS, chief of research and evaluation at MHSOAC, told HealthITAnalytics.


“All of these different state-level systems capture a piece of someone’s mental health story. To fully understand the investments, you need to collect and connect the data to find out whether you’re fulfilling the mission of reducing those seven negative outcomes.”


“Not all mental health advocates are what I would call data researchers. But you still need to make sure that they can use this rich data to advocate and make policy decisions, both within the community and at the state level,” said Early.



Organizations such as MHSOAC are proving that data is a trend that is here to stay when it comes to improving the behavioral health system.


Methadone and Suboxone


Suboxone and methadone are two different medications used to treat opioid use disorder. They are a big focus in the Behavioral Health industry right now.


  • Suboxone is a combination of two medications: buprenorphine and naloxone.

    • Buprenorphine is a partial-agonist opioid used to reduce cravings and withdrawal symptoms.

    • Naloxone is an opioid blocker added to discourage abuse.

  • Methadone is a synthetic opioid used to reduce cravings and withdrawals.


Suboxone and Methadone have distinct differences, but both are individually successful addiction treatments (although they can become addictive, as well). ‌


As for ease of use, Suboxone may be started without a doctor’s supervision. Most doctors can prescribe it within or outside a dedicated drug addiction program. However, it requires a higher dose than methadone for treatment and is less effective in avoiding opioid relapses.


Methadone is also easier to use in flexible dosing. Flexible and take-home dosing can make it easier for patients to stay on their treatment plan and avoid relapse.



Future


Commitment to advanced technology and better care has brought about countless new trends within the behavioral health industry. In a previous blog post, we covered what technology will influence the future of this field, but here are two trends we think will also be significant players in the years to come.


Value Based Care


In 2017, the Commonwealth Fund conducted a report that compared the healthcare systems of eleven different high-income countries. This report found that the United States spent significantly more money and resources on healthcare but somehow ranked at the bottom for performance and access, equity, and healthcare outcomes.


Americans consistently list healthcare as a top concern, and employers continue to search for ways to curb spending while ensuring patients receive the resources and care they need. Value-Based Care (VBC) is a popular proposition that promises to assist practices in achieving better health outcomes at lower costs.


Currently, most individuals view the healthcare system as a place that helps individuals after they’re already sick. VBC seeks to change this by adopting a proactive, team-oriented, and data-driven approach to keeping individuals healthy and improving the healthcare experience.



You may already be familiar with VBC and perhaps even seen it in action in some practices, but it still is relatively new to the behavioral health sector. It already provides promising results and answers that many are looking for in the US healthcare system. Because of this, we think it will likely be a big trend in the industry in years to come.


Expanded Medicaid Coverage


We also see an expansion in Medicaid coverage & increase in government oversight as a likely trend in the coming years.


Hospitals that care for more people on Medicaid or for people that are uninsured, in the end, are reimbursed far less than facilities that operate in areas where there are more people covered by private insurance. Between 2000 and 2018, at least 85 rural hospitals closed their doors to inpatient care due to low reimbursement rates and other financial concerns.


Under the current structure, the federal government subsidizes state mental health coverage between 2 and 9 dollars for each dollar the state spends. This disproportionately benefits wealthier states with larger budgets as they can receive more matching funds. It also encourages healthcare expansion through this federal multiplier. Some have suggested that a higher federal involvement and subsidy elimination level could level the playing field and create efficiencies. Look for proposals on this front, as they could be dramatic.




Preparing your Organization for New Trends


As the need for mental and behavioral health services continues to grow, so will the tech that supports the industry. Your organization must be prepared for new tech and trends so that you can best serve your patients and clients. Here are a few ways you can better prepare your organization now:


1. Stay up-to-date on current trends and technology: By keeping an eye on current trends and technology in the field, you will be aware of new technology that can better serve your clients and your community.


2. Prepare your data: Data integration is crucial for developing new technology that can help practices predict trends and treat patients. At Pinnacle Health Informatics, we can assist in collecting and presenting data intuitively and understandably, allowing you to manage your practice efficiently, predict trends more effectively and advance your practice into the future. This is often up to 80% of the work in any data project. Clean, conformed, and deduplicated data leads to excellent results.


3. Follow leaders in the industry: Follow reliable individuals and organizations that can provide insight into new trends. Some trends will not be as reliable or useful as others, and these leaders can often help sift through what is worth the hype and what is likely to pass.


4. Ask questions and seek help: Sometimes, it is hard to move forward when you are stuck on a complex issue or problem. Seeking professional help to identify trends or issues within your organization is an essential step to progression.



We can help!


Pinnacle Health Informatics has specialized in the behavioral health sector for more than two decades, and throughout our time working with clients, we have seen the industry adapt and grow in numerous ways. We pride ourselves on staying on top of current trends and supporting our clients within the industry to the best of our abilities.


We are eager to assist you in building reliable data dashboards that will prepare your organization for whatever lies ahead and improve current operations. Reach out today to find out how we can help.


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