Forum focuses on mental health

02/24/2013 12:00 AM

10/06/2014 5:56 PM

It's a grim estimate often cited by public health officials: About a fourth of all people will experience a mental illness or disorder at some time in their lives.

Apply that formula to the 2.15 million people in the four-county Sacramento region and you get 537,500 residents who, theoretically, may need mental health care at some juncture.

Is our health care system prepared to handle behavioral health needs of this magnitude?

Hardly, according to a blue-ribbon panel of experts assembled for a round-table discussion last week at the Sierra Health Foundation.

Convened by U.S. Rep. Doris Matsui and state Senate President Pro Tem Darrell Steinberg, the meeting was the first in a series of discussions aimed at improving public access to mental health services.

The group included representatives from major health plans, mental health program executives, physicians, a child psychiatrist and top officers from nonprofit advocacy groups.

Participants took a step back to ask fundamental questions: How can people access the mental health care that's already available in the community? How can hospitals be encouraged to hand off behavioral health patients to these existing programs?

"This is a complex issue on one hand," said Steinberg. "On the other hand there's a simple question and that is, for a person with a loved one living with a mental illness, what can they do to get help?"

Steinberg described the current system as fragmented and Byzantine.

Noting that December's Newtown, Conn., school massacre has kept a spotlight on prevention in mental health, Matsui said now's the time to press for improvements and early intervention.

"If you get a diagnosis early enough, you really are in a sense preventing bad things from happening," Matsui said.

"Mental illness can be devastating," she said, recalling her own sister's promise and potential before she descended into schizophrenia.

Child psychiatrist Dr. Jason Bynun said behavioral health issues should be caught early, but at the same time there's a dearth of child psychiatrists – only 15,000 nationwide.

Only 4 percent of medical school graduates pursue careers in psychiatry, Bynun said, because the specialty is far from lucrative.

On some levels, access to care may become easier thanks to a federal parity law and the Affordable Care Act, which requires health insurers to cover mental health just as they do physical health.

But it remains to be seen to what extent health insurers are willing to invest in treating mental disorders.

At least one major insurer was called out during the meeting for refusing to pay for rehabilitative care for a patient.

Matsui said health plans need incentives to embrace prevention early on. Others backed her up.

"What needs to be done is to make the business case to the health plans on how this would be profitable or save them money," said mental health advocate Gale Bataille.

Hospitals also need to be prompted to provide meaningful care – not just park patients in gurneys in whatever hallways are open, participants said.

The Sacramento four-county region, where health care is one of the most prominent industries, has just one hospital that offers both general and mental health care to patients – Woodland Memorial Hospital.

Dignity Health, its parent company, recently committed to adding 10 more beds to Woodland Memorial's psychiatric unit within months. That would bring the total number up to 30.

Other hospitals in the area have psychiatric wards in which to hold patients, but employees are not trained to care for the patients' mental and physical health together.

The next gathering of the group will focus on presenting data that appeals to the profit motives of health plans, so they commit to quality behavioral health care.


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