Improving Access to Evidence-Based Psychological Care

Access to evidence-based psychological care […] is limited, according to a report commissioned by Big Health and conducted by actuarial consulting firm Milliman.

Health Affairs

Access to evidence-based psychological care, including cognitive behavioural therapy (CBT), for Medicare beneficiaries with mental health conditions such as depression, generalised anxiety disorder, insomnia, post-traumatic stress disorder, and eating disorders is limited, according to a report commissioned by Big Health and conducted by actuarial consulting firm Milliman. The report found that a significant proportion of traditional Medicare beneficiaries diagnosed with generalized anxiety disorder and insomnia did not receive psychotherapy, despite clinical guidelines recommending it as first-line treatment. Instead, some patients were prescribed riskier second-line drugs with potential adverse effects.

 

The report also highlighted challenges in the clinical workforce, with a shortage of behavioural health specialists, long wait times for new patients, and inadequate reimbursement mechanisms. Focus should be on increasing access to evidence-based psychological care, with potential solutions including changes to the clinical workforce, care delivery, and payment models.

Key Takeaways

 

  • Psychological treatments, such as CBT, are considered the gold-standard for mental health conditions, but for many who need it, access is limited. This despite clinical guidelines recommending CBT as first-line treatment.

  • Some beneficiaries were receiving riskier second-line medications, such as benzodiazepines and hypnotics, before receiving evidence-based first-line behavioural interventions like CBT.

  • Digital mental health interventions, such as teletherapy and online CBT programs, could be a solution to increase access to evidence-based psychological care.

  • Challenges in the clinical workforce, including a shortage of behavioural health specialists, long wait times, and inadequate reimbursement mechanisms, hinder access to psychological care, making scalable digital mental health interventions a viable option.

  • Digital mental health interventions have the potential to enable better care by overcoming access barriers and increasing the availability of evidence-based psychological treatments. This would help close the gap between the care patients should be getting versus what they are actually getting. 

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The views shared are those of the authors and do not necessarily reflect those of eMHIC. This content is for general informational or educational purposes only and is not a substitute for professional mental health advice, diagnosis, or treatment. If you are experiencing a mental health crisis, please immediately contact local emergency services or a crisis support service in your area.
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