Dr. Beecroft: We urge medical providers to be alert to secondary behavioral health issues

Health care providers play an integral role in helping patients navigate between inpatient care to outpatient services, according to Dr. William Beecroft, medical director of behavioral health at Blue Cross Blue Shield of Michigan. Appropriate identification of health issues and proper follow-up care can streamline the process, decrease the number of visits to multiple providers and improve continuity of care for the patient.

This is essential for providing our patients — and even our own family members — with effective, efficient and coordinated mental health care.

Many patients who are admitted to the hospital for chronic or acute medical conditions may exhibit certain symptoms that help practitioners identify other health ailments so that appropriate testing and interventions can be performed. However, what about the symptoms such as sadness or fear that may not easily be recognized or that may be hidden by the physical symptoms? Chronic medical conditions and mental health disorders often are concurrent with one another, with the mental health condition being overlooked.
Mental health disorders often go unnoticed until a catastrophic event occurs — one that reveals the severity of the patient’s mental health status. According to the National Alliance on Mental Illness,** approximately 1,469,000 adults in Michigan have a mental health condition. Yet more than half of these individuals didn’t receive proper treatment for their condition.

This lack of recognition of mental health disorders for those hospitalized with a medical condition is one of the top barriers associated with continuity of care. A recent statistical analysis** revealed that out of 12,000 patients admitted to the hospital with a medical condition, only 140 of these patients were referred for a psychiatric evaluation, yielding a referral rate of just 1.17%.

These statistics are concerning because one of the main goals of patient care is early detection of any underlying mental health issue that may be negatively affecting the patient’s physical health and impeding their daily functioning. Our findings at Blue Cross are similarly concerning: Less than 5% of members hospitalized with a new behavioral health diagnosis received proper treatment and follow-up care.

As a result of this lack of identification and follow-through during hospitalization, these patients often get released from the hospital without the appropriate mental health follow-up care. An internal study revealed that approximately 25% of members didn’t receive follow-up care after discharge. Follow-up care is extremely important, especially for those who have been diagnosed with a new or existing behavioral health concern.

Discharging patients can be a very complex process, depending on individual circumstances. There are many components to consider when it comes to discharging patients, including the ability of patients to care for themselves, ensuring they have a safe place to stay, an allotment of initial medications, a plan for continuation of those medications and follow-up or appointments that the member may need. We need to ask ourselves: Does the patient understand the process, their diagnosis and what is needed after discharge? Addressing these issues may not be easy, but there are certain actions that can be taken to help overcome the barriers, such as the development of an appropriate treatment plan.

Statistics** indicate that approximately 80% of people with a behavioral health disorder will seek treatment from their medical clinicians. Clinicians face challenges in identifying behavioral health disorders since the symptoms may not be as easily identified as medical conditions. More emphasis needs to be placed upon early identification of mental health disorders and ensuring that a complete and thorough health assessment is completed on all patients hospitalized for a medical condition.  Once it’s determined that a mental health issue exists, an inpatient consultation with a behavioral health specialist should take place so that the member’s needs are addressed accordingly and the appropriate treatment plan can be implemented — both inpatient treatment and post-discharge follow-up.

We believe that trained professionals should take the opportunity to become as diligent about identifying mental health disorders as they are with medical problems. Asking the appropriate questions and providing patient-centered care in a collaborative setting can have a big impact on a patient’s overall well-being and, potentially, save lives.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.