No matter where behavioral healthcare practitioners are located these days, we face the dual challenge of responding to the economic hardships of our clientele as well as those affecting our own organizations.
According to NAMI, the World Health Organization has warned that the global financial crisis will likely cause increased mental health problems and suicides as people cope with poverty and unemployment. The Los Angeles Times cites a paper published in the General Archives of Psychiatry revealing that high-status people who experience a loss of job, income, or marriage had the highest risk of any group of committing suicide. The study used data collected from 96,000 psychiatric patients in Denmark. USA Today notes that, according to the Employee Assistance Professionals Association, EAP calls have increased 10% since the spring.
“Being there” is what we are all about. It’s what we have always been about. But many—if not most—behavioral health provider organizations are encountering financial challenges of their own. The Energy Information Administration predicts an 18% increase in the cost of heating with natural gas; a 23% increase for heating oil; an 11% increase for propane; and a 10% increase to heat using electricity. According to the Segal Health Plan Cost Survey, health insurance costs in 2009 will increase by 10% – 13.2%, depending on the type of plan involved. Our employees expect and need, at a minimum, cost-of-living increases. And the list goes on.
Here in Indiana, the state’s Medicaid program has not increased its behavioral health reimbursement rates during my 15-year tenure here. Commercial insurance rates are about the same. According to the Indiana Council of Community Mental Health Centers, persons served in the state mental health system increased by 57% in eight years, while the adjusted funding per client decreased by 25% over the same period. Sound familiar to those of you in other parts of the country?
We will continue to “be there” for the people we serve. But we may not be able to respond to our communities in the same everything-to-everyone mode that we have sought during our quixotic past. We will be subsidizing acute care over lower intensity situations, even though we know that there is a risk of problem exacerbation later on. We will be fine tuning our efficiencies even more. We will be going green and eliminating waste and redundancy. We will be using technology to find solutions to ever-burgeoning expenses. We will learn to say no to money-losing initiatives that we have agreed to in the past. We know that the safety net will not be fully intact, but we will do our best to mend it as rips appear!
P.S. A note of thanks to my colleague John Sears of Greencastle IN, who faithfully sends me blog info, some of which is included in today’s posting.