Strengthening access to behavioral health will help Kanzans and address far-reaching differences

Kansas Reflector welcomes opinions from writers who share our goal of broadening the conversation about how public policies affect the daily lives of people in our state. Tiffany Anderson, superintendent of Topeka USD 501, and Shannon Portillo, associate professor and professor at the University of Kansas, were co-chairs of the Governor’s Committee on Racial Justice and Justice; David Jordan, president and chief executive of the United Methodist Ministry of Health Fund, chairs the subcommittee on health.

The Governor’s Committee on Racial Justice and Justice has repeatedly heard from community members, stakeholders and those working in criminal justice for unmet behavioral health needs and how the lack of access to behavioral health care – both mental health services and drug treatment – leads to lawful forced meetings.

People with behavioral health problems are three to six times more likely to be represented in the criminal justice system.

In addition, the data show racial differences in the effects of behavioral health systems on color communities. For example, levels of drug use are similar in different racial and ethnic groups, but black and brown communities experience greater substance use problems, such as legal issues, the participation of the judiciary and social consequences.

The Commission has examined behavioral health, seeking to understand how to deal with systemic problems that affect health outcomes, community vitality, crisis response and access to health care. Recommendations on behavioral health to address racial justice were included in the committee’s final report.

Law enforcement officials ultimately act as de facto providers of behavioral health. Investments need to be made to increase the use of behavioral health training for employees to better prepare them for safe de-escalation and resolution of mental health emergencies.

Cooperation between local authorities, law enforcement agencies and behavioral health providers can enhance the way law enforcement responds to behavioral health incidents. One successful model is the correspondence program, in which mental health professionals work with law enforcement to answer mental health calls. Virtual models are also promising. This model contributes to positive outcomes and promotes treatment instead of imprisonment for people experiencing mental health crises.

To deal with systemic behavioral health problems, we need to invest in early interventions. Behavioral health services need to be lifelong and more accessible to all.

Mental health services should be targeted at pregnant and new mothers so that they can benefit from earlier diagnosis and treatment. We need to study and treat prenatal and perinatal depression to improve maternal and child health outcomes.

To deal with systemic behavioral health problems, we need to invest in early interventions. Behavioral health services need to be lifelong and more accessible to all.

– Leaders of the Governor’s Commission for Racial Justice and Justice

Kansas should use the DC: 0-5 Diagnostic Guide, which classifies mental health and developmental disorders for children ages 0 to 5, to improve the ability of mental health professionals to diagnose and treat mental health disorders and to facilitate reimbursement of Medicaid costs for appropriate treatment.

Children need to be insured so that they can access behavioral health services. Kansas has a growing number of uninsured children. Between 2016 and 2019, the non-insurance rate for children increased from 4.9% to 5.8%. In 2019, children who were racial and ethnic minorities were 3.6 times more likely to be uninsured than white children who were not Hispanic. Applying continuous coverage to children aged 0 to 5 would reduce the number of children who refuse Medicaid for administrative reasons.

In addition, Medicaid must reimburse the cost of evidence-based interventions, such as home visits and early literacy programs that build safe, secure, nourishing relationships that improve health, education, and economic opportunities.

We need to ensure that children receive behavioral health services in an early learning environment, rather than being disciplined, which can have lifelong consequences. According to a study by Yale University, preschoolers are expelled more than three times more often than K-12 students. Expulsion rates are lower in conditions where preschool teachers had access to behavioral counselors in the classroom. The Commission recommends increasing the availability of infant / early childhood mental health counseling in the country to ensure that children receive age-appropriate behavioral health support.

It is important to improve access to behavioral health care in educational settings. Possible initiatives include coordinating with local authorities to ensure that school-based services are available to the wider community, extending the hours of school behavioral health clinics, ensuring that schools become Medicaid providers so that they can directly charge and offer services in multiple languages.

Patients of all ages will benefit if behavioral health services are better integrated into our existing health care system and if the state supports the use of technologies such as telehealth or application-based providers to make behavioral health services accessible.

Medicaid’s current tolerance limits are too low. Kansas needs to expand Medicaid, which will increase access to health care and reduce uncompensated care – reducing costs for all. Hospitals and behavioral health centers should automatically help eligible patients enroll in Medicaid on discharge, increasing Kansans’ access to behavioral health services after discharge.

All levels of government can improve data tracking and coordination between behavioral health systems, such as the criminal justice system. This should include maintaining data on race and ethnicity for behavioral health incidents involving parents and young children to inform them of the necessary interventions.

All Kanzans would benefit from improved behavioral health services and access. To make these recommendations a reality, we must call on our local and national representatives to support these changes, which will improve Kanzan’s health and address long-standing differences.

About this series

In June 2020, Governor Laura Kelly signed Executive Order 20-48, forming the Governor’s Commission on Racial Justice and Justice. The Commission examined issues of racial and equity in Kansas systems, focusing first on police and law enforcement and then on economic systems, education and health. The Commission has developed recommendations for government agencies, the legislature and local authorities. By the end of 2022, the Commissioners will delve into the recommendations in a monthly series.

Through its opinion section, Kansas Reflector works to strengthen the voices of people who are affected by public policies or excluded from public debate. Find information, including how to post your own comment, here.

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