Behavioral Health Moonshots
I have an assignment at work to look at Behavioral Health strategies. Many of them are designed to fit within the standard medical model, provide incremental change to how we do Behavioral Health. While there’s much to be said about the merits of step-wise progress, I find that approach uninspiring. Instead, I want to catalog several moonshoot ideas what would immediately improve behavioral healthcare in the US.
Medical Model: You have a physiological ailment that is causing psychological issue, we prescribe drug or therapy, the drug or therapy treats the physiological ailment.
1) Eliminate Chart Reviews: Today, insurance companies get to decide for mental-health practioners are doing a quick enough and good enough and the right type of job in treating their patients. Most of these reviews are not completed by mental health professionals at the insurance company and are explicitly fitting them into the medical model. Adopting this stance treats therapists as experts, and enables many other types of therapy to be put to use. If we care about outcomes, this model produces better outcomes.
2) Cover All Billing Codes: Today, most insurance companies limit the types of billing codes available for coverage, including family therapy and marriage therapy. We know that health improvements, financial stability, stress reduction are all tied to our nearest and dearest relationships, so this idea feels like a no-brainer.
3) Skip the DSM: Today, mental health practitioners are largely beholden to identifying a specific diagnosis code in order to get paid. Talk with any provider in this space, and they will tell you about a patient they’ve had that didn’t quite fit into a diagnosis. Ask them about patients that were worse off because of a diagnosis. In general, the insurance companies’ demand to that people fit into a nice DSM code strikes me as a paternalistic and like the old medical model of healthcare.
4) Encourage caffeine and nicotine use: This one is a wild one, but caffeine and nicotine are relatively harmless stimulants that also suppress appetite. Suppressing appetite decreases food consumption, which will decrease obesity and lower food spending. Lower obesity increases overall health.
5) Baby Boxes: Whether its through the education, the box itself, or the attention it draws to infant mortality, baby boxes have been a rousing success at reducing infant deaths. What if your insurance company sent you a baby box when your child was born?
6) Volunteering over SSRI’s: Imagine going to your psychiatrist and instead of writing you a prescription for Zoloft, they write a prescription for volunteering at your local soup kitchen. Apparently, volunteering has several amazing health benefits, including lower hypertension rates, higher feelings of fulfillment, increased oxytocin.
More to follow!
