Maryland’s new Behavioral Health Care Treatment and Access Commission discusses plan for reforming behavioral health during its first meeting

The Maryland Behavioral Health Treatment and Access Commission held its first meeting last month to discuss the report's findings and next steps.

under House Bill 1148The commission, passed by the Maryland General Assembly earlier this year, is required to create four workgroups. One on the behavioral health of older adults, one on the behavioral health of adolescents, and one on the behavioral health of individuals with developmental disabilities and complex behavioral health needs. One is for the behavioral health of those involved in justice. The other is behavioral problem workgroup development, infrastructure, coordination, and funding.

Sarah Barra, chief of staff for the state Department of Behavioral Health, provided a detailed analysis of the commission's initial needs assessment.

“We want to think of behavioral health as a continuum of care. What we really want to understand is prevention, promotion, primary behavioral health and early intervention, acute emergency care, treatment and All of these pillars, such as recovery, are one continuum, meaning people can be in different places at different times depending on their needs.”

— Barra

Compared to 2021 data, 2022 data showed a 7.6% decrease in fatal overdoses in Maryland. The Maryland Department of Health (MDH) is in the first phase of analysis and will continue to analyze data and trends within each of the four workgroups. Issues for future discussion include what additional information and analysis is needed to advance the workgroup's discussions and recommendations, and how the committee can better address unmet needs and demands for services and resources. This includes things like whether you can understand it.

Jordan Fisher, MDH Chief of Staff for Operations and Health Systems, analyzed the reports used to guide each of the four workgroups and provided recommendations for each. MDH focuses on research and evaluation of crisis services for older adults, including the policy, operational, and other requirements needed to promote and provide crisis services across the state. We have considered four of his reports.

The report also examines the provision of appropriate long-term care in Medicaid for older adults, identifies the current cognitive and behavioral health needs of Maryland's aging population, and explores ways to address those needs. provided.

“The recommendations in these reports primarily include strengthening pre-admission training and resident screening programs, establishing an interagency coordination process on aging, and strengthening the ability to age appropriately for people with severe mental illness. “We focus on a residential rehabilitation program model,” Fisher said.

Additional recommendations include establishing crisis walk-in and mobile crisis team models in each jurisdiction, addressing workforce shortages, funding and accountability measures, and ensuring transportation access.

MDH identified nine reports for use in the Youth Behavioral Health Workgroup, primarily focused on youth-centered behavioral health prevention and intervention techniques.

“Through this review, we will consider an integrated behavioral health model, a pilot program in Maryland that utilizes a co-design model, recommend additional programs for transition-age youth, expand capacity in residential treatment centers, and more.” , we found some important recommendations,'' Fisher said.

MDH used a total of 19 reports to review complex behavioral health needs, with a particular focus on disparities in overdose deaths, costs and expenditures related to serious and persistent mental illness. . Key recommendations for complex behavioral health needs include increasing data collection and analysis on opioids, evaluating medication adherence strategies, increasing treatment resources, and reducing stigma.

MDH analyzed 16 reports for law enforcement stakeholders to improve the continuum of care for mental health services and crisis response systems across the state, ease of access to substance use disorder treatment, and access to care. focused on improving.

“Key recommendations from these reports suggest increasing treatment resources in leading correctional facilities, including access to diversion programs and substance use disorder treatment, and increasing forensic services and hospital bed capacity. “There are,” Fisher said.

MDH made recommendations to address behavioral health workforce development, infrastructure, and coordination, noting the lack of health care providers trained to treat co-occurring disorders, as well as the lack of social workers and substance use disorder providers. Based on 12 reports. . Additionally, the report notes high turnover among behavioral health workers, which can be attributed to burnout and non-competitive pay. Recommendations include increasing recruitment and retention efforts for psychiatrists and nurses, especially in rural areas.

MDH analyzed six reports related to behavioral health care, identifying the need for increased spending in specific areas of the behavioral health care system, such as psychiatric rehabilitation programs, and the creation of new residential substance use disorder benefits. focused on the need for.

“Recommendations from these reports focused on cost-containment strategies for psychiatric rehabilitation programs, along with related recommendations for the public behavioral health system,” Fisher said.

The four working groups have met once since the committee's first meeting. Each workgroup has prepared a report based on the information shared at the first committee meeting and will meet again on December 18 to discuss future work in more detail.