Improving Preventive Behavioral Health to Avoid a Crisis

As the health system evolves to a whole-health approach, prevention of illness and a focus on overall well-being becomes ever more prominent. This shift in focus may be most noticeable and most needed in behavioral health. It’s far too common for people to reach a behavioral health crisis before getting the support and treatment they need.

A preventive mental health and substance use approach requires two fundamental shifts in public sentiment. The first is toward widespread acceptance that behavioral health is health. The second is to decrease negative stereotypes around seeking diagnosis and treatment.

As public attitudes toward behavioral health shift, the health system can increase support for behavioral health at the individual and community level, as well.

Many behavioral health concerns begin in or before adolescence but go largely unrecognized and untreated before adulthood. Expanding the use and scope of routine screenings, especially for children, will help identify appropriate early interventions — from developing social and emotional skills to creating supportive environments to prescribing treatments like therapy and medications.

Even in adulthood, many people at risk of or with diagnosed behavioral health concerns don’t get the treatment they need. In fact, less than half of people with a mental illness get any treatment in a given year. It is critical to proactively identify people who have behavioral health concerns, so they can get support and care that addresses their needs early and helps them manage and sustain their health.

Helping communities become more informed about behavioral health can increase acceptance of behavioral healthcare, help more people recognize early warning signs, and proactively support people’s whole health.
 

Starting Preventive Behavioral Healthcare Early

It’s never too early to start preventive behavioral healthcare, as most behavioral health concerns have roots in childhood. Behavioral health interventions for children younger than 5 years old have even been linked with better adult health outcomes.

Trusting relationships between children and their caregivers can lead to honest conversations about children’s feelings and observations of their reactions. Parents can share these conversations and observations with their child’s primary care provider.

Careful consideration of what parents share and more routine behavioral health screenings at primary care visits can help providers proactively determine when children need extra evaluation. The American Academy of Pediatrics recommends that psychosocial and behavioral assessments begin at birth, with more specific screenings for concerns like depression and substance use beginning in early adolescence. These assessments have the potential to prevent mental illness or treat it early, as studies have found that half of mental health conditions develop by age 14.

While these assessments are crucial, they often don’t look at the significant social drivers of health. Childhood stress and trauma, such as abuse, homelessness, or instability in the household, and childhood poverty have been found to negatively impact behavioral and physical health, even into adulthood. Social drivers of health should be integrated into behavioral health screenings.

“We urge primary care providers to assess children not only for health and typical development, but for stressors and risks that may contribute to the onset of mental health and substance use disorders: social drivers such as food insecurity, exposure to violence, discrimination, parents’ mental health or substance use, and other environmental factors,” said Dr. Steven Korn, a child and adolescent psychiatrist and Elevance Health behavioral health medical director.
 

Connecting People with the Right Help

While providers identify potential behavioral health concerns through routine screenings, health plans can proactively use data analytics to identify people who are at risk of a behavioral health crisis.

Beacon Health Options, our behavioral health service company, uses data to help connect more people to care before their conditions escalate. In 2021, this led to Beacon investing in additional screening tools and making thousands of outreach calls.

During Beacon’s outreach calls, they found that 28% of people contacted had unmet social needs that affected their health. Exposures to violence, social isolation, and discrimination significantly contribute to the development of mental health and substance use disorders. Poverty remains a risk factor in adulthood, with links to depression, anxiety, psychological distress, and suicide.

Understanding the physical, behavioral, and social drivers of behavioral health conditions can illuminate the best path forward for each person. It could be anything from peer support to housing to managing a chronic illness.
 

Improving Community Behavioral Health

As those in the health system work to identify and address needs of individuals, we can create environments that are more conducive to whole health. This includes:

• Supporting community-based interventions that build neighborhood trust and safety, mitigate violence and crime, and improve social connectedness.
• Increasing access to therapy, peer supports, help with higher education, care management, appropriate medication, and integration between school and community care.
• Offering training and support for people who interact with children, such as parents, teachers, clergy, and youth organization leaders.

After decades of behavioral health being treated as a functionally separate arena from physical health, the health system is progressing toward a whole-health approach that considers physical, behavioral, and social drivers of health in harmony. This is very promising for prevention of and early intervention in mental health and substance use disorders.