How Robust Care Coordination Can Help Us Deliver Effective Behavioral Health Crisis Care

Jefferey Metcalfe

CEO of Bamboo Health. Over 20 years of healthcare/tech experience with leadership roles at McKinsey and Company, Anthem and Healthways.

The Covid-19 pandemic has exacerbated a mental health epidemic and an already bleak behavioral health resource crisis facing our country today. According to recent research results, the U.S. has experienced a significant jump in the number of adults reporting anxiety and/or depressive disorder symptoms, growing from one in 10 in 2019 to four in 10 by early 2021. This alarming statistic is further complicated by provisional data from the CDC’s National Center for Health Statistics reporting over 106,000 drug overdose deaths in the U.S. during the 12 months ending in November 2021.

Our nation’s leaders are taking notice, with both Congress and the Biden Administration working on overlapping plans to address behavioral health and substance use issues. In the 2022 State of the Union Address, President Biden reinforced his commitment to tackling America’s escalating mental health crisis. Shortly thereafter, the White House released a fact sheet detailing the President’s proposed initiatives, including shoring up the workforce, particularly with this summer’s imminent launch of “988” as the three-digit code for the National Suicide Prevention Lifeline.

This is a move deemed by many as the most significant public policy initiative impacting behavioral health care since Medicaid expansion. In addition, legislators have added to these efforts with bills to support increased funding for technology and associated services ahead of the launch of the suicide prevention line.

Although the creation of an easy-to-remember number like 911 for behavioral health needs represents a tremendous movement in the right direction, the reality is that many cities, counties and states are simply not prepared to implement the initiative effectively. Fielding these calls can be extremely impactful in mitigating crises, but this is only the first step. Getting callers to the treatment they need and the providers or placements that can help them will require adequate resources and robust technology infrastructure.

Implementing An Effective Behavioral Health Crisis Response

Currently, there are approximately 200 regional crisis centers across the U.S. that will be required to field calls via 988 by the impending July 16, 2022, deadline. However, for states and local governments already facing a plethora of public health challenges due to the lingering effects of the Covid-19 pandemic and beyond, identifying where to start is a daunting task.

To make the vision of the 988 lifeline a reality and a success, the best starting point is to implement a behavioral health crisis response system that can coordinate services effectively and ensure that teams and technologies can closely interact and cooperate with each other. These services include dispatching, appointment scheduling, hospital bed registry and more.

Improving Access To Behavioral Health Treatment

To reach this goal, it’s crucial to determine what’s working well and pinpoint areas for improvement by reviewing the current crisis care coordination system. It also helps to identify limits in the technology infrastructure, such as insufficient access to data or breaks in communication between dispatching emergency service teams and other key providers.

In addition, it’s important to put into place the critical technology infrastructure elements to ensure that the trained professionals answering 988 calls can appropriately address the needs of those suffering from behavioral health emergencies. This includes the ability for digital intake and assessment, deployment of mobile crisis teams and facilitated communication between crisis call center staff directly with mobile crisis response teams. It also encompasses access to service and bed availability via a real-time bed and outpatient appointment capacity and referral management system for complete visibility into providers’ capacities and available treatment programs.

To do this, care collaboration—facilitated by technology—between stakeholders across the continuum is crucial. This includes those working in crisis call centers, mobile crisis units, departments of behavioral health, law enforcement agencies, hospitals and healthcare facilities who must be able to quickly respond to mental health emergencies by providing or referring patients to the proper care.

Finally, an interoperable technology infrastructure among different call lines and EHR systems is required to facilitate real-time awareness of and connection to crisis response teams on a shared platform. By integrating health data interoperability and real-time data availability in a single, integrated network, stakeholders could gain a complete view of each patient’s longitudinal record. These insights can enable providers to manage every part of a patient’s journey, inform policy and program design and make more cost-effective use of resources.

Looking Ahead To The Delivery Of Whole-Person Care

Although we’ve made significant strides in tackling our nation’s mental health and substance use crisis that has cut too many lives short, we still have a long way to go to move beyond the current piecemeal approach to behavioral health crisis care. By developing a comprehensive, interoperable behavioral health crisis system, we can offer more integrated services to deliver whole-person care from call to treatment when and where patients need it the most.


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