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A needs-based method for estimating the behavioral health staff needs of community health centers.

Burke BT, Miller BF, Proser M, Petterson SM, Bazemore AW, Goplerud E, Phillips RL - BMC Health Serv Res (2013)

Bottom Line: More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients.Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients.Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap.

View Article: PubMed Central - HTML - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. Bridget.Teevan@gmail.com

ABSTRACT

Background: Federally Qualified Health Centers are expanding to increase access for millions of more Americans with a goal of doubling capacity to serve 40 million people. Health centers provide a lot of behavioral health services but many have difficulty accessing mental health and substance use professionals for their patients. To meet the needs of the underserved and newly insured it is important to better estimate how many behavioral health professionals are needed.

Methods: Using health center staffing data and behavioral health service patterns from the 2010 Uniform Data System and the 2010 National Survey on Drug Use and Health, we estimated the number of patients likely to need behavioral health care by insurance type, the number of visits likely needed by health center patients annually, and the number of full time equivalent providers needed to serve them.

Results: More than 2.5 million patients, 12 or older, with mild or moderate mental illness, and more than 357,000 with substance abuse disorders, may have gone without needed behavioral health services in 2010. This level of need would have required more than 11,600 full time providers. This translates to approximately 0.9 licensed mental health provider FTE, 0.1 FTE psychiatrist, 0.4 FTE other mental health staff, and 0.3 FTE substance abuse provider per 2,500 patients. These estimates suggest that 90% of current centers could not access mental health services or provide substance abuse services to fully meet patients' needs in 2010. If needs are similar after health center expansion, more than 27,000 full time behavioral health providers will be needed to serve 40 million medical patients, and grantees will need to increase behavioral health staff more than four-fold.

Conclusions: More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients. Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients. Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap.

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Related in: MedlinePlus

Past year prevalence of mild or moderate mental illness or illicit drug or alcohol abuse by insurance type. * Average past year mental illness and illicit drug or alcohol abuse for public insurance and uninsured. † Average past year mental illness and illicit drug or alcohol abuse for private insurance and Medicare. (Source: 2010 National Survey on Drug Use and Health). # Psychologists, licensed clinical social workers, and other licensed mental health professionals were grouped together for analyses as “licensed mental health providers”.
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Figure 2: Past year prevalence of mild or moderate mental illness or illicit drug or alcohol abuse by insurance type. * Average past year mental illness and illicit drug or alcohol abuse for public insurance and uninsured. † Average past year mental illness and illicit drug or alcohol abuse for private insurance and Medicare. (Source: 2010 National Survey on Drug Use and Health). # Psychologists, licensed clinical social workers, and other licensed mental health professionals were grouped together for analyses as “licensed mental health providers”.

Mentions: The NSDUH indicates those covered by Medicare have similar rates of mental illness to those with private insurance. Similarly, the uninsured and those with Medicaid/CHIP have similar rates of mental illness (Figure 2). We used insurance data from the UDS to group medical patients for each grantee into two categories: 1) Medicaid/CHIP/Other public insurance and uninsured, and 2) Medicare and private insurance. Applying prevalence data of past year mental illness by insurance type from the NSDUH, we estimated the number of patients age 12 and over likely to have mild or moderate mental illness , our target population for mental health treatment. Estimates were calculated for all grantees, including those without current mental health staff or patients. We excluded serious mental illness from this analysis because we assumed patients with SMI had a high likelihood of receiving mental health care in other safety net mental health settings, and the median number of visits per patient would greatly underestimate the need for providers to serve this population.


A needs-based method for estimating the behavioral health staff needs of community health centers.

Burke BT, Miller BF, Proser M, Petterson SM, Bazemore AW, Goplerud E, Phillips RL - BMC Health Serv Res (2013)

Past year prevalence of mild or moderate mental illness or illicit drug or alcohol abuse by insurance type. * Average past year mental illness and illicit drug or alcohol abuse for public insurance and uninsured. † Average past year mental illness and illicit drug or alcohol abuse for private insurance and Medicare. (Source: 2010 National Survey on Drug Use and Health). # Psychologists, licensed clinical social workers, and other licensed mental health professionals were grouped together for analyses as “licensed mental health providers”.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750356&req=5

Figure 2: Past year prevalence of mild or moderate mental illness or illicit drug or alcohol abuse by insurance type. * Average past year mental illness and illicit drug or alcohol abuse for public insurance and uninsured. † Average past year mental illness and illicit drug or alcohol abuse for private insurance and Medicare. (Source: 2010 National Survey on Drug Use and Health). # Psychologists, licensed clinical social workers, and other licensed mental health professionals were grouped together for analyses as “licensed mental health providers”.
Mentions: The NSDUH indicates those covered by Medicare have similar rates of mental illness to those with private insurance. Similarly, the uninsured and those with Medicaid/CHIP have similar rates of mental illness (Figure 2). We used insurance data from the UDS to group medical patients for each grantee into two categories: 1) Medicaid/CHIP/Other public insurance and uninsured, and 2) Medicare and private insurance. Applying prevalence data of past year mental illness by insurance type from the NSDUH, we estimated the number of patients age 12 and over likely to have mild or moderate mental illness , our target population for mental health treatment. Estimates were calculated for all grantees, including those without current mental health staff or patients. We excluded serious mental illness from this analysis because we assumed patients with SMI had a high likelihood of receiving mental health care in other safety net mental health settings, and the median number of visits per patient would greatly underestimate the need for providers to serve this population.

Bottom Line: More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients.Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients.Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap.

View Article: PubMed Central - HTML - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA. Bridget.Teevan@gmail.com

ABSTRACT

Background: Federally Qualified Health Centers are expanding to increase access for millions of more Americans with a goal of doubling capacity to serve 40 million people. Health centers provide a lot of behavioral health services but many have difficulty accessing mental health and substance use professionals for their patients. To meet the needs of the underserved and newly insured it is important to better estimate how many behavioral health professionals are needed.

Methods: Using health center staffing data and behavioral health service patterns from the 2010 Uniform Data System and the 2010 National Survey on Drug Use and Health, we estimated the number of patients likely to need behavioral health care by insurance type, the number of visits likely needed by health center patients annually, and the number of full time equivalent providers needed to serve them.

Results: More than 2.5 million patients, 12 or older, with mild or moderate mental illness, and more than 357,000 with substance abuse disorders, may have gone without needed behavioral health services in 2010. This level of need would have required more than 11,600 full time providers. This translates to approximately 0.9 licensed mental health provider FTE, 0.1 FTE psychiatrist, 0.4 FTE other mental health staff, and 0.3 FTE substance abuse provider per 2,500 patients. These estimates suggest that 90% of current centers could not access mental health services or provide substance abuse services to fully meet patients' needs in 2010. If needs are similar after health center expansion, more than 27,000 full time behavioral health providers will be needed to serve 40 million medical patients, and grantees will need to increase behavioral health staff more than four-fold.

Conclusions: More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients. Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients. Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap.

Show MeSH
Related in: MedlinePlus