We must improve access to mental health care on Long Island

Almost everyone on Long Island who attempts to begin counseling or psychiatric medication management is met with unanswered calls and frustration. State Attorney General Letitia James’ recent investigation into mental health care access problems underscores the urgent need to improve our mental health system. Unsurprisingly, her study found that 86% of calls to establish mental health care were unsuccessful.

There are several reasons why access is so difficult. As James indicated, insurance companies do not keep their directories up to date. Providers frequently attempt to update information but are met with roadblocks by the insurance companies, a frustrating circle that drives providers out of network. As an in-network mental health nurse practitioner for many years, I have experienced countless frustrations dealing with insurance bureaucracy. Coupled with provider shortages, Long Islanders are left in a precarious position with unmet care needs.

It is urgent that we address the mental health care access crisis. It’s time to think outside the silos of our current health care system. Innovation is crucial, and integrating mental health care into the physical health or primary care settings is an effective, efficient, and less-stigmatizing way to improve access to mental health care. Why are mental and physical health separated in the first place? We intuitively understand that these phenomena are linked, and the truth is that in our broken system, primary care providers are managing mental health conditions every day with little support.

Integration can be as straightforward as co-locating a licensed mental health provider in or near the primary care provider’s office for ease of referrals. However, other models of care can be readily implemented into primary care settings with minimal education, support, and funding for primary care providers. The collaborative care model embeds a counselor and psychiatric provider directly within the primary care office structure, either virtually or in-person. Often, the patient can be evaluated and treated in-network, in a setting where they are familiar and comfortable, within days instead of weeks or months down the line. According to the University of Washington, some 90 rigorous studies demonstrate the efficacy and value of integrative collaborative care. This model supports primary care providers and maximizes staff resources, while reducing frustration, wait times, and burden for Long Islanders.

Long Island’s robust primary care workforce is well-positioned to lead the state in this innovation. According to the New York State Office of Mental Health Collaborative Care Medicaid Program, there are only 12 primary care offices with established collaborative care programs operational in Suffolk County. State records show scarcely more in Nassau. Other forward-thinking primary care practices have implemented various forms of integrative care, but they are few and far between. It is vital we identify and treat mental health concerns quickly and efficiently to prevent mild symptoms from escalating to serious, debilitating conditions. Mental health treatment integrated into the primary care setting needs to be the new standard of care.

Ultimately, we need to call on our health care organizations and primary care providers to adopt integrated models of care. Resources are available through state agencies, like the Office of Mental Health, for primary care practices considering integration. From there, Long Islanders should encourage legislators to support the uptake of integrative care by making one-time implementation grants a state budget priority. Startup funding can reduce the initial economic strain for primary care providers and get these programs into more practices.

Integrated care can help reduce the frustration that costs lives.