If there is one constant in today's politics, it's that everyone wants more money for his/her cause. From astronomy to zoology, every conceivable field, business, and area of interest has a lobbying group pushing its agenda on Capitol Hill. Some have more influence than others, but all ultimately are competing for a sliver of the federal pie. The process is repeated at the state and local levels.
And everyone's demand for more funding seems insatiable. That's a shame, given the state of the country's finances and the additional debt we surely will amass as the baby boomers age.
The behavioral health field is no exception. Advocates call for more funding for behavioral healthcare on a daily basis, and I readily acknowledge that more indeed is needed to better care for our nation's mentally ill and/or substance abusing population. But how much more?
I've grown weary of hearing speakers at conferences and field leaders call for more funding without following up with specifics. I'm guilty of this myself (and I'm the son of an accountant!). It's an easy way to rally the troops. It makes for great sound bites. But it only adds our clamors for more funding to the already deafening chorus surrounding lawmakers.
Of course, there is no magic number. This field has so many needs that perhaps all we can do is ask for more. But something tells me we can do better than that.
We've had plenty of reports describing the extent of the country's substance abuse and mental health needs (we've duplicated our efforts many times). Now we need to know how much it really will cost to meet the needs of people with behavioral health problems. This is a complicated endeavor for sure, made even more so by the difficulties in identifying what treatment involves and then quantifying it for payment purposes. With use of evidence-based treatments and outcome measures still in their infancy in this field, payers are rightfully questioning whether treatments make a difference. And with no money to spare, we need to make sure they do.
Therefore, the field needs to determine the effectiveness of the treatments it offers, provide evidence that they're working, and determine how much it would cost to apply them to meet our population's needs. This certainly is no easy task, but perhaps having such information available would help us to make our case when we ask for more funding.
Douglas J. Edwards, Editor-in-Chief