Forum on Mental Health and Substance Use Disorders – författare

The persistent trends in suicide necessitate action among mental health care providers and payers, researchers, and community leaders. Health care settings provide an important opportunity for suicide intervention and prevention, but they cannot yet fully manage suicide risk because of a lack of training, knowledge gaps, and reimbursement challenges. School, workplace, and community-based interventions can help reduce the incidence of suicidal behavior, as can better access to care and reduced access to lethal means of suicide.

To better understand the strategies to improve access to effective interventions to prevent suicide, the Forum on Mental Health and Substance Use Disorders at the National Academies of Sciences, Engineering, and Medicine hosted a two-part virtual public workshop, Strategies and Interventions to Reduce Suicide, on June 22, 2021, and July 28, 2021. The first webinar examined the scope of the public health problem, discussed implementation of effective approaches for suicide prevention care, and addressed known barriers to health care access. The second webinar focused on building 9-8-8, the new nationwide emergency number designated to the National Suicide Prevention Lifeline. Participants discussed current crisis systems, gaps, challenges, and needs for marginalized populations. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshops.

Behavioral health and substance use disorders affect approximately 20 percent of the U.S. population. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. Together, these disorders account for a substantial burden of disability, have been associated with an increased risk of morbidity and mortality from other chronic illnesses, and can be risk factors for incarceration, homelessness, and death by suicide. In addition, they can compromise a person''s ability to seek out and afford health care and adhere to treatment recommendations.

To explore data, policies, practices, and systems that affect the diagnosis and provision of care for mental health and substance use disorders, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine created the Forum on Mental Health and Substance Use Disorders. The forum activities are expected to advance the discussion and generate potential ideas on ways to address many of the most persistent problems in delivering mental health and substance use services. The inaugural workshop, held October 15-16, 2019, in Washington, DC, explored the key policy challenges that impede efforts to improve care for those individuals with mental health and substance use disorders. This publication summarizes the presentations and discussion of the workshop.

Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders.

In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine''s Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.

Emerging real-time data sources, together with innovative data science techniques and methods - including artificial intelligence and machine learning - can help inform upstream suicide prevention efforts. Select social media platforms have proactively deployed these methods to identify individual platform users at high risk for suicide, and in some cases may activate local law enforcement, if needed, to prevent imminent suicide. To explore the current scope of activities, benefits, and risks of leveraging innovative data science techniques to help inform upstream suicide prevention at the individual and population level, the Forum on Mental Health and Substance Use Disorders of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop series consisting of three webinars held on April 28, May 12, and June 30, 2022. This Proceedings highlights presentations and discussions from the workshop.

Studies show that people commonly have psychotic symptoms for over a year before receiving treatment. Reducing this duration is critical, because early treatment is strongly associated with better outcomes. The National Academies Forum on Mental Health and Substance Use Disorders hosted a workshop in July 2022 to examine the current evidence on short- and long-term outcomes for people at high risk for psychosis. Speakers explored potential policy solutions and strategies that are most effective for coordinated, early-intervention specialty services. This Proceedings document summarizes workshop discussions.

The mental and behavioral health care needs of Americans, including veterans, have substantially grown over the past few decades. As the nations largest provider of mental health care, the U.S. Department of Veterans Affairs (VA) faces some of the greatest challenges in meeting the mental health care needs of its population. These challenges are exacerbated by a shrinking mental health care workforce and provider shortages in low-income and rural communities. To address these challenges, and at the request of VA, the National Academies of Sciences, Engineering, and Medicine Forum on Mental Health and Substance Use Disorders held a public workshop on Improving Access to High-Quality Mental Health Care for Veterans to explore the U.S. landscape for mental health care services, including telehealth services. The workshop considered ways to improve veterans timely access to high-quality care for mental health conditions. In particular, it explored internal and external best practices for three critical needs for mental health access (known as tripartite access in VA): urgent/crisis, engagement, and sustained access. This proceedings document summarizes discussions at the workshop.

Existing systems are not prepared to provide the mental health care services needed by the growing population of older adults. The National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop in May 2023 to highlight the current state of mental health care for older adults, outline the challenges they face, and explore potential long-term strategies and solutions for addressing unmet mental health needs. Discussions emphasized information about wellness and prevention, social determinants of health in aging populations, the impact of workforce shortages and gaps, the need for supportive healthy communities, and strategies to promote positive mental health.This publication summarizes the presentations and discussion of the workshop.

At the request of the Health Resources and Services Administration, the National Academies Forum on Mental Health and Substance Use Disorders hosted a public workshop in April 2024 to explore mental health care services related to anxiety and mood disorders in women. Speakers provided evidence to identify, define, and prepare strategies for the provision of essential health care services for women experiencing anxiety and mood disorders. Presentations also described health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.