Promoting Access to Behavioral Health Care

Accessing high-quality, patient-centered mental and behavioral health care is a challenge for all Americans, particularly for communities who have been historically under-resourced and marginalized and face unique barriers to care.

U.S. Mental Health Crisis

Prior to the COVID-19 public health emergency, mental health challenges among youth and adults were increasing, but over the duration of the pandemic, there was an even sharper increase. As case numbers grew and conditions worsened, afflicted individuals continued living without proper access to care due to a multitude of barriers that kept mental health care encounters low and disparate across demographic groups around the country. Since then, there is a growing amount of information about the significant shortages in the behavioral health workforce, lack of mental health parity with medical care, barriers due to insurance policies, network inadequacy, and other challenges.

As part of the AAMC's ongoing efforts to improve access to health care for all, we seek to leverage the strengths of academic medicine to improve mental and behavioral health care access through integrated, evidence-based, and technology-enabled care delivery models in primary, specialty, and maternity care.

We have developed two primary focus areas in the promotion of mental health care access: advancing integrated behavioral health (IBH) models at academic health systems and fostering collaboration and shared learning to improve maternal mental health care outcomes.

Integrated Behavioral Health

IBH, providing medical and behavioral health care together, is an evidence-based strategy that utilizes team-based coordinated care models for enhancing access, improving patient outcomes, reducing stigma, and promoting health care equity.

The AAMC is committed to advancing and promoting the implementation of IBH models in both primary and specialty care and identifying the optimal use of technology as a complement to these models of care. Learn more about Integrated Behavioral Health.

Maternal Mental Health

Perinatal mental health challenges, such as depression, anxiety, and mood disorders, are the most common pregnancy complications and are the leading causes of pregnancy-related deaths in the United States. These challenges remain under-diagnosed and under-treated. The AAMC is working to highlight opportunities for OB-GYNs and other pregnancy health care professionals, pediatricians, and mental health specialists to work together to address access gaps to mental health care for pregnant and postpartum individuals and their families throughout the perinatal period.

The AAMC is dedicated to working with academic health systems and external partners to highlight and educate around the successes and challenges in improving maternal mental health outcomes through clinical interventions and care models. The association launched a learning series focusing on the unique approaches academic health systems and nonprofits are taking to better maternal mental health for patients. The learning series brings together clinicians, mental health providers, and advocates to share knowledge and resources. Learn more about Maternal Mental Health.

Substance Use Disorder Care

Substance use disorders (SUDs) such as opioid use disorder, alcohol use disorder, and others, currently impact the health and well-being of over 20 million people in the United States, including pregnant parents, minors, and infants. However, many challenges persist in this field of care, including data tracking, understanding polysubstance use, addressing punitive state policies, reducing stigma, and ensuring equitable access to high-quality care.

The AAMC’s newly published data snapshot uses 2023 billing data from the Clinical Practice Solutions Center to analyze differences in clinical diagnosis patterns for SUDs by health care service line, diagnosis type, payer, and patients’ demographic profiles. It underscores the need for further exploration into when and how SUDs are identified and what disparities exist in diagnosis and access to treatment.

Leveraging Technology to Expand Mental Health Care Access

Digital health tools such as e-consults, psychiatry access programs, and provider-to-provider learning programs can be utilized to supplement some of the gaps in care created by the mental health workforce shortage. These tools facilitate remote provider consultations, expedite mental health referrals, and serve as a vehicle for disseminating screening, diagnostic, and treatment information that can support primary care and specialty providers. Using technologically supported care produces skill-sharing and flexibility within the health workforce. The AAMC is working with member institutions to understand how telehealth and other digital tools have been successfully leveraged by teaching hospitals to expand access to care.

This data snapshot outlines the importance of telehealth to increase access to mental and behavioral health services at academic health systems.

Advocacy and Resources

The AAMC is also engaged in a variety of advocacy-related activities that bolster the voice of academic medicine and fuel policy changes that expand mental health care parity and accessibility. The following resources demonstrate our engagement with policymakers and regulatory agencies alongside our member institutions and peer organizations to champion greater access to behavioral health care.

Advocacy

• This mental and behavioral health advocacy agenda explores recommendations for policymakers to strengthen the workforce, integrate physical and behavioral health care, and promote parity and access.
• Learn about the AAMC’s virtual congressional briefing, which includes the association’s legislative recommendations to expand the behavioral health workforce. (Oct. 14, 2022)
• Comment letter to the U.S. Department of Health and Human Services, the U.S. Department of Labor, and the Internal Revenue Service discussing requirements related to the Mental Health Parity and Addiction Equity Act. (Sept. 25, 2023)
• Comment letter to the Centers for Medicare & Medicaid Services with recommendations on hospital outpatient payments, quality proposals, and requests for information. (Sept. 8, 2023)
• Comment letter to the House Energy and Commerce Committee leadership on the Restoring Hope for Mental Health and Well-Being Act and the Advanced Research Projects Agency for Health Act. (Jun. 22, 2022)
• Comment letter endorsing the Strengthen Kids’ Mental Health Now Act, which would increase Medicaid reimbursement for pediatric mental health services. (Apr. 27, 2022)
• Comment letter detailing policy recommendations to the U.S. Senate Finance Committee promoting access to behavioral health care. (Nov. 15, 2021)

Briefs and Data Snapshots from the AAMC Research and Action Institute

• An issue brief about the barriers to mental health care, as well as key focus areas policymakers should prioritize to improve access, coverage, and affordability.
• This article emphasizes the importance of innovation in service delivery, collaborative models, expansion of behavioral health into primary care settings, and the recruitment and retention of psychiatrists. (Oct. 26, 2023)
• An issue brief that examines the history of health workforce projections modeling in the United States, with a goal of assessing the validity of various approaches. (Jun. 29, 2023)