The business of behavioral Health
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Jan, 31th 2015
Introduction
Behavioral health is level or otherwise the state of well-being psychologically in a person. The situation exists once there is no mental disorder. An individual who is mentally sound happens to function at a balanced behavioral and emotional adjustment. It further comprises the ability of an individual to cope with the normal stresses that occur within the lifetime of an individual, contribution to one’s community and the productivity of a person among others. Behavioral health covers the entire bit of overall mental health. An individual who happens to have a behavioral health challenge is often a victim of stress, anxiety, grief, relationship issues, learning disabilities, depression, being moody among other psychological problems. It is thus correct to say that persons with behavioral wellness issues often face difficult challenges in their lives. The challenges are daily and usually, they are affected in the way they execute their various duties. Deterioration in the mental health thus affects the life of a person gradually in the mild cases. In some cases, it may invoke other bodily illnesses which in turn lead to complex body diseases. The situation can even lead to the death of the particular victim.The paper seeks to establish behavioral business service as an autonomous part of the health care services. It distinguishes its existence from other entities of health care. It further outlines why its funding should be done differently than other health care services. The paper goes ahead to stipulate some of the challenges that of operating within the environment. The areas that the behavioral health care conflicts with other areas of health care and so on. In addition to that, it seeks to answer the question whether managed care environment will cater for residential treatment (Patel, 2010).
As a Profession
The behavioral health care service is definitely viewed as a separate field from the rest of the health care fields. Some of the professions who operate in the field include: counselors, psychologists, life coaches, physicians by providing medications, therapist to mention but a few. Such expatriates provide vital input into the field by applying their knowledge into the fields. Global mental health which is an aspect of behavioral wellness carries study, research as well as practice all aimed at accomplishing mental health equity of all persons in the world. It can thus be said that behavioral wellness is a profession on its own that seeks to achieve and maintain mental health. It is thus profession that survives on its own without relying on other areas. By recognizing the profession, it will possible to have it operate independently. It will thus be a good move towards ensuring the field grows on its own and expands. It will further be able to cater for variety of needs within the field (Scheffler, 2011).
Difference between Behavioral health and rest of health care
The difference in between behavioral health and the rest of the health care can be viewed from different fronts. The first can be traced from the diagnosis bit. Different books are used while diagnosing a behavioral health. The Diagnostic and Statistical manual of Mental disorder (DSM) is employed while doing the process of diagnosis. The rest of health problems are diagnosed via the use of International Statistical Classification of Disease and Related Health Problems (ICD). Diagnosing differently serves as one of the major differences. The next difference can be viewed from a social perspective. In most cases, individuals suffering from behavioral health problems often are victims of stigma. A mentally ill person for instance, will be stigmatized by the society hence discriminated against than a fellow victim of diabetes. The society thus has a different reception of an individual suffering from the mental health. The other difference can be traced from an economic perspective. Most insurance companies have health insurance plan that hardly pays attention to the behavioral health. Other health care perspectives are given preference than the behavioral one. The health assurance policies only pay attention to the other aspects of health. The situation overlooks the existence of situation whereby the behavioral health is not given attention. It is thus very vital to have healthcare industry distinct from the behavioral health care service. The move will work to ensure that the special needs of the behavioral health care industry. Operating differently from the rest of the industry will further work to assist in developing measures to curb the situation. The industry having been marginalized for so long will thus be able to operate autonomously thus achieving the overall goal of sound behavioral health (Cox, 2006).
Why It Should be Reimbursed Differently
The field should be reimbursed differently as it is totally different field from other fields of health care. There is thus the need for special care. The reimbursement will thus ensure that the victim in case of such occurrence is clearly catered for. Specialty of the area further calls for specialized personnel hence procuring such a person is not the same as it can be for the other services. The next factor is due to cost. The cost of such services is relatively higher than other health care costs. The individual thus requires to be reimbursed differently ensuring that the cost of engaging such an expatriate is well compensated. The reason is the presence of the policy. The policy developed made sure that it’s addressed in a different manner. The Mental Health Parity Act was a legislation that recognized the need to reimburse the behavioral health. As a result of the stipulations and provisions of the legislation, the reimbursement provided should be done totally differently from other health care costs. The law thus recognizes the need for the separation of the two types of costs (Oss, 2005).
Challenges faced by behavioral health care providers under managed health care
Behavioral health care providers has had a number of challenges related to administrative duties, increased demand for the service and the issue of behavioral health being subjective. On the issue of administrative duties, there has been rise in the cost of providing the services. Due to the increased, there is great need to have proper records of the dealing in order to justify the need for increase in the contribution under managed care. The issue is that there is increased demand due to issues such as economic recession which thus stretches on spending of the provider as managed care always targets at low cost health care. The next issue is on the subjectivity of the behavioral health issue. The behavioral health cannot be addressed as other health care issues. It is more subjective than medical cost. That means that each and every case is totally different from the other. Furthermore, behavioral health being different from other forms of health care cannot be addressed the same way other medical costs are handled. Operating under managed care thus means limiting the resources that may be applied hence not addressing the issue completely.
Conflicting areas
The conflicting areas are thus on cost due to limits imposed by managed care, individuals going for less managed care plans that do not accommodate their concern, controls on the patient admission and discharge hence some patients are discharged earlier than supposed among others. Among the conflicting areas, is the concept of cost. The reason behind is because on exhaustion of the plan adopted by an individual, the provider cannot go beyond that. That means the individual is half treated hence still in danger of recurrence of the problem. The managed care limits resources for treatment of persons (Kongstvedt, 2001).
Managed care environment and residential treatment
Currently, the managed care cannot be able to support the services of residential treatment of behavioral health issues. The concept of behavioral health cannot be equated to the other services of health care. It calls for bit of attention as it different from the rest of health care fields. The residential treatment can only be managed if behavioral health care is addressed on its own. By that, it means it will be separate and autonomous in its operations. The plans that will be adopted by the providers will thus be tailored to meet the behavioral health needs. There will no such issues such as strained resources hence when trying addressing the concept of health care (Kongstvedt, 2001).
Conclusion
Behavioral health care is the mental wellness of a person. It covers the wide concepts of emotions, the biology of mental well-being and entails behavior plus the ability to effectively function in daily activities of individuals. The counselors, therapists, life coaches among other specialist operate in the field in order to improve service provision in the sector. It is thus a separate profession from the rest of health care provision services. It seeks to establish the equity of mind such that individual mind is able to operate and balance stresses in life. The difference between behavioral health and other fields can be seen from social perspective, economic perspective as well as from medical point of view. From the social end, individuals suffering from behavioral health are often stigmatized than others suffering from any other health issue. The economic perspective is seen by health care providers or otherwise insurance companies. The companies provide mostly plans that are not related to behavioral health issues. That makes the behavioral health issue be overlooked. The medical perspective can be seen as far as diagnosis is concerned. Diagnosis of behavioral health is done via different books (DSM) while other health care diagnosis is done via ISM (Covall, 2005).
Reimbursement should be done differently due to costs of behavioral health service which are higher than other services. In addition, it should be done differently due to specialty of the field and the law governing it. The field requires expatriates hence procuring their services require proper attention. There is also a law that stipulates on the separation of the two services. The Mental Parity Health Act outlines the separation. The challenges faced by the providers are the increased demand for such services and rising cost among others. Managed care and residential is relatively hard to accommodate due strained resources by managed care. However, by having behavioral health care operate differently, it will be possible for residential treatment to be availed (Covall, 2005).
References
Covall, M. (2005, January). Medicare prospective payment comes to psychiatric hospitals. Behavioral Health Management, 25(1), 54–57.
Cox, T. (2006). Professional caregiver insurance risk: A brief primer for nurse executives and decision makers. Nurse Leader, 4(2): 48–51
Kongstvedt, P. (2001). The Managed Health Care Handbook. Fourth Edition, Aspen Publishers, Inc.
Oss, M. E. (2005). What"s next for managed behavioral health. (Cover story). Behavioral Health Management, 25(6), 11-14
Patel, V. (2010). Global mental health - a new global health field comes of age. JAMA 2010, 303(19):1976-7.
Scheffler RM et al. (2011). Human resources for mental health: workforce shortages in low- and middle-income countries. Geneva, World Health Organization Press.