We have a mental-health crisis in the Northwest, across the country and around the world. The COVID-19 pandemic has created additional challenges for our mental health. Four in 10 U.S. adults report symptoms of depression or anxiety, and 1 in 10 say they have seriously considered suicide.
To address this crisis, we need local and national investment in proven approaches to increase access to effective mental health care.
Washington state is a national leader in developing such solutions. On Sept. 10, U.S. Reps. Jaime Herrera Beutler, R-Battle Ground, and Lizzie Fletcher, D-Houston, introduced important bipartisan legislation that supports the implementation of collaborative care.
The collaborative-care model, an approach pioneered in Washington state, helps primary care providers and practices to address common mental-health and addiction problems in primary care. This approach builds on the trust between primary care providers and their patients, and adds in crucial support from a trained behavioral health care manager and an experienced psychiatric consultant.
In a familiar setting, patients benefit from the full range of mental-health treatment options, from medication to behavioral therapy, and patient progress is systematically reviewed to ensure that they are improving.
Over the past decade, more than 90 studies have demonstrated that collaborative care improves patients’ access to care and improves their mental and physical health. Primary care providers and patients both report higher satisfaction.
Total health care costs are lower, too: $12 saved for every $1 spent for treatment of depression in adults, according to the Washington State Institute for Public Policy. The collaborative-care model is reimbursed by Medicare, most private insurers and an increasing number of state Medicaid programs, including Washington’s.
When it comes to this powerful approach to improve access to care, Washington has important experience to share with the rest of the country. Our state Legislature has made steady investments in collaborative care for more than a decade.
Even before Medicaid’s expansion, Washington expanded access to mental-health care for unemployed individuals on short-term disability in more than 100 community health clinics in partnership with the Community Health Plan of Washington.
More recently, the state committed to implement high-quality integrated behavioral health care by adopting the Bree Collaborative Behavioral Health Integration standards, which incorporate core elements of the collaborative care model. Gov. Jay Inslee and the state Health Care Authority have made important commitments to integrate physical and behavioral health care, and state legislators have funded Collaborative Care training in partnership with the University of Washington’s AIMS Center (Advancing Integrated Mental Health Solutions).
In the same spirit, we call on local, state and federal governments to support a full range of mental-health and addiction programs. The legislation proposed by Reps. Herrera Beutler and Fletcher would further strengthen our nation’s capacity by enabling our primary-care colleagues to address the overwhelming behavioral-health needs in their practices.
There are no silver bullets to address our current mental-health crisis. But one silver lining of the COVID-19 pandemic may be our greater willingness to acknowledge our mental-health struggles. It has become more common and acceptable to discuss resilience and to seek help when we are struggling with stress, burnout or problems such as addiction.
As psychiatrists who have spent decades working to improve access to effective mental-health care, we welcome and support the legislation being considered by Congress as an important opportunity to share an innovative, “made in Washington” solution with the rest of the country, and to help millions of Americans struggling with mental-health and addiction problems.