The consensus of many health care researchers and policymakers around the country is that care for mental health and substance use disorders (MH/SUDs) needs to be integrated into traditional health care systems to create a team-based delivery model that focuses on the whole person. Currently mental health care and substance use treatment, often grouped under “behavioral health,” exist in a totally separate and often neglected system, leading to inefficient care, poorer outcomes, and higher costs.

In 2014, the results of a community needs assessment that highlighted gaps in the region’s behavioral health care prompted the five major hospital systems of South Jersey to team together with the New Jersey Hospital Association and the Camden Coalition to create the South Jersey Behavioral Health Innovation Collaborative (SJBHIC). The SJBHIC commissioned the Camden Coalition to research the impact of rising mental health and substance abuse diagnoses on the region’s emergency departments and inpatient units.

We decided to find out where the breakdowns in service were by studying the 834 people who used all five hospital systems between 2010 and 2014. Eighty-two percent of these patients had a mental health or substance use disorder diagnosis. These 686 patients alone received $260M worth of care, for which the hospitals were paid only $31M.

On April 18, the results of this research were presented to SJBHIC at an event that featured former Congressman Patrick Kennedy, who has become a national leader on mental health and addiction policy, as keynote speaker. “Mental health affects everybody and we have to take away this veil that it’s just for ‘those’ people,” he said.

Integrating mental health and addiction services with traditional physical health is uniquely difficult in New Jersey. A recent report from researchers at Seton Hall University Law School found that cumbersome licensing requirements and difficulty obtaining Medicaid reimbursement for behavioral health services are preventing many otherwise willing behavioral and primary care providers from integrating their practices. For example, CarePlus New Jersey, an integrated behavioral health center in North Jersey, has had to obtain five separate licenses from the state in order to provide their integrated services.

The five hospital systems of SJBHIC: Cooper University Health Care, Inspira Health Network, Kennedy Health, Lourdes Health System, and Virtua, have committed to working together to modernize their health care delivery systems and move towards an aligned, person-centered approach. This will mean increased case conferencing, placing behavioral health specialists in emergency departments s, standardized protocols and education, and support for Housing First services. Right now SJBHIC is working to pilot a regional care planning initiative using our Health Information Exchange.

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