According to a 2016 study by Health Affairs, hospital emergency departments have witnessed a dramatic 55% increase in mental health visits over the last ten years, including those involving substances: 2002 saw 4.4 million instances of patients seeking treatment in the ER for a mental health issue; 2011 logged 6.8 million visits.

And late last year the Agency for Healthcare Research released a report focusing on emergency department visits that stemmed from opioid use. Between 2005 and 2014, that rate surged by a shocking 99%.

More than half of Americans with mental healthcare needs go without care

All this to say that emergency departments and primary care clinics are having great difficulty meeting the demand for behavioral health treatment. And beyond the strain on healthcare facilities and practitioners, there is the issue of the lack of or unreliable access to treatment for patients. The National Alliance on Mental Illness reports that there are around 44 million individuals in this country currently coping with a behavioral health challenge, and over the past year, almost 60% of them failed to receive treatment.

Directly speaking to this crisis of care, earlier this month Providence St. Joseph Health announced details of grants awarded by its Well Being Trust (initially known as the Institute for Mental Health and Wellness), grants designed to explore solutions for a system currently groaning under its own weight.

The behavioral health foundation of Providence St. Joseph Health has a $100 million fund allocated for improving access to and outcomes in mental health treatment. The first three recipients of grants from Well Being Trust are the California Mental Health and Wellness Initiative, the Trust for America’s Health, and the Institute for Healthcare Improvement. Providence’s Well Being Trust intends to work with the grantees on initiatives that boost availability to behavioral health services in primary care and hospital environments.

Well Being Trust employs a “social movement approach”

Well Being Trust was begun by Providence last summer with the purpose of “advancing the mental, social and spiritual health of the nation,” according to its website. And additionally: “By applying a social movement approach, Well Being Trust will invest in clinical and community transformation initiatives, advocate for healthy public policy at all levels, drive compelling communications and social engagement campaigns, and grow the evidence base for what works to improve human and community wellbeing.”

Some of Well Being Trust’s specific goals include strengthening the resiliency of individuals and families; helping patients overcome obstacles to care so that they get the treatment they need; de-stigmatizing mental health treatment; and offering help to individuals suffering with substance use disorder, depression, and anxiety.

The foundation’s opening endowment was $100 million. In addition, another $30 million was earmarked for work in California.

Trust seeks a true community approach to behavioral health

Dr. Rod Hochman is president and CEO of Providence St. Joseph Health. He told Modern Healthcare that Well Being Trust is unlike others of its sort because it doesn’t only look to solve the problem of mental health access from within the healthcare industry, but rather, it seeks to expand the problem-solving potential by joining with civic organizations like fire departments and schools. “Our hope is that other large health systems will join us in this effort,” he said.

The $30 million grant awarded to the California Mental Health and Wellness Initiative is providing that organization with the means to carry out a three-year project that mirrors the work of Well Being Trust: creating care bridges from healthcare facilities to communities.

Well Being Trust’s project with the Trust for America’s Health involves the creation of approaches for advocacy in states giving attention to behavioral health issues like substance use disorder, depression, and suicide. The two organizations will also collaborate to come up with policy suggestions for those states.

And finally, the foundation will collaborate with the Institute for Healthcare Improvement on a measure to explore approaches for folding mental health care into emergency departments so that patients needing such care will access necessary services in a timely manner. According to Mara Laderman, Director of Innovation at the Institute, this grant-funded project is expected to be carried out over the course of two years, will involve eight to ten healthcare providers, and will also work closely with contacts in the community in addressing the prevention of behavioral health crises that would be the impetus for an ER visit.


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