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Four barriers to future integration

April 14, 2011
by Dennis Grantham, Editor-in-Chief
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What “basic issues” need to be addressed before behavioral healthcare can move forward?

In mid-March, I attended the 2011 summit meeting of ACMHA: The College for Behavioral Health Leadership, joining about 150 professionals in examining the issues that stand between where the behavioral health field is today and where we will want to be tomorrow. (Be sure to read ourrecent story from Ron Manderscheid, in which he shares his own thoughts on the ACMHA Summit.) For those who haven’t been introduced to ACMHA, its charter is to identify and address questions of concern to American public policy, principally through wide-ranging, collegial discussions at its annual summit. And, while this summit is known for bringing together outstanding and influential leaders, ACMHA is also working hard to foster new leadership, so many younger professionals, interns, peers, and others were also in attendance.
This year’s summit topic, “disruptive innovation” in behavioral healthcare, was aptly chosen, given the passage of the Affordable Care Act just one year ago. While the future under ACA-driven reforms bodes well for the behavioral health of Americans, summit goers predicted that few in our field will get there without making major changes. Those unable to change won’t get there at all. As some argue for a broader role for behavioral healthcare in a reformed healthcare system, our future is clouded by some very basic issues, especially when observed from the “outside in,” noted Paul Keckley from Deloitte, the summit’s keynote speaker. While what we do every day is obvious to us, behavioral health still:

  1. Remains a mystery to virtually all in the medical establishment—notably primary care practitioners—our presumed future partners.
  2. Resists quality measurement using many traditional measures of outcome—the gold standard established for medicine and payment.
  3. Demands a more complex set of tools than traditional medicine, a combination of medical and social interventions whose impact and value are poorly understood outside of the field.
  4. Is rarely appreciated by individuals unless their lives, or the lives of others close to them, are adversely affected by a behavioral health problem that leads to loss of job, education, social relationships, or other aspects of what we consider to be a meaningful life.

Needless to say, we’ve got some work to do.

To find out what other questions, comments and suggestions were introduced by ACMHA attendees this year, stay tuned for the rest of my editorial (“ A view from the Summit”) featured in the April 2011 issue.