Project 1: The “all-important behavioral care analysis” project

Most of the time somebody uses a behavioral health care provider and that visit is paid for by insurance, data on that visit is collected. The Health Insurance Portability, Access and Accountability Act (HIPAA) means that health visits are reported in the aggregate. You can’t see whether a particular person received care, but you can know how many women aged 30–39 received care, for example. Gaining access to behavioral health information is harder than other data, because laws and policies see this information as sensitive due to the enduring stigma about mental illness. It is also cumbersome for many kinds of behavioral health providers to manage billing insurance companies for care, so they make the patient file the claim.

No one number will provide a complete picture of a community’s health. By gathering multiple data sources and tracking them over time, you should be able to get an idea of how much behavioral health care insecurity exists in your community. Here’s your list:

• Available data: Your state Behavioral Health or Mental Health Department should have aggregate data for the whole state and maybe some by county.
• Sources of care: Locate the sources of behavioral health care, both private and public. Include the following: emergency rooms, urgent care centers, doctor’s offices, hospitals, community health centers, free clinics, school clinics, pastoral counseling centers, social workers, licensed mental health counselors and psychologists.
• Access limitations: Determine the operating hours and eligibility requirements for every source. Do they take Medicaid, Medicare, self-pay patients? Do you have to be a US citizen to get care?
• ER data: How many behavioral health patients does the hospital Emergency Department serve each year? How many of these cases are transported by ambulance? How many of those patients were there due to violence, injury or threat to harm self or others? Were these patients identified and tracked for behavioral health issues?
• Community mental health center: Does your community have one? Does a federally-qualified health center or tribal health center have a behavioral health staff?
• Free clinic data: Does your community have a free clinic? How many patients can it handle on average? Is care restricted to certain age groups or other populations?
• Clergy: Many clergy provide initial behavioral health support to their members. You may have to call pastors/faith-based organization leaders. Note how many sessions they offer on average, and whether they have a credential in pastoral care or behavioral health.
• Elder service agencies: How many have social workers or other behavioral health care providers on staff? Who is eligible for care?
• School districts: Is there a school-based health center in your community? What services are provided, what age group(s) do they serve? How many visits occur in an average month? Do your schools have volunteer or paid school nurses on staff?
• Homeless shelters: Many serve substance using or mentally ill clients routinely. Who do they call when they can’t manage a client with behavioral health or addiction issues?
• Domestic violence shelters: They may track visits to shelter program supports. Maybe take a snapshot once per month and track over time.
• Child welfare data: While not easy to acquire, there may be a way to assess data on adult and child clients needing behavioral health care.
• American Community Survey: The ACS is an ongoing survey that provides vital information on a yearly basis about the United States and its people. Information from the survey generates data that help determine how more than $675 billion in federal and state funds are distributed each year.

As mentioned, this won’t be as simple an assessment as those for other sectors, but if you get these numbers, you should be able to tell if the situation in your community is going in a good or bad direction. In this project, you will be gathering as much data as you can to paint a picture of local behavioral health care, the first step in identifying challenges.