​In light of growing evidence linking behavioral and physical health, Modern Healthcare published a special report on "healthcare's overlooked disease." Between 15% and 30% of people with diabetes also have depression, the report said, and 33% of heart attack sufferers later experience depression. Studies suggest that treating the physical health of a patient with an underlying behavioral health disorder can be as much as three times as expensive as treating a patient without such a disorder. One health system discussed in the report found that 26% of its medical inpatients had a behavioral health issue, leading to $26 million in excess costs for the health system and adding an average of 1.07 days to length of stay. There is no single model to address this issue, the report said. The problem stems from multiple causes. Patients with behavioral health disorders delay treatment because of the costs, while providers are not employing enough psychiatrists and counselors to fully meet demand. One analysis suggests that the United States as a whole has only about 44% of the number of employed mental health professionals it needs. The report includes sections on the role of primary care providers in addressing behavioral health; government support for treating mental health (including speculation on whether bipartisan support will continue in the future); and the problems caused by the increase in behavioral health patients in hospital emergency departments (EDs) nationwide. The number of patients visiting EDs for mental health issues jumped by 55% nationally between 2002 and 2011, the article said, but the number of psychiatric beds available nationally plummeted by nearly 80% from the 1970s through 2010. This creates a situation that is unsafe for everyone in the ED, the article said. One system addressed this by creating behavioral health "holding areas," where patients who have been cleared on medical issues can be moved, and by hiring its first full-time ED psychiatrist. The system is also establishing a behavioral emergency response team that can be summoned at any time. It also began providing a telepsychiatry service.

HRC Recommends: Many mental health problems remain unrecognized or untreated by healthcare providers, leaving many individuals and families struggling. Risk managers should identify whether emergency department staff, physicians and independent healthcare practitioners, and nurses in their facilities have received training in behavioral health screening to facilitate earlier identification of behavioral health and substance use disorders that can be alleviated by timely care.