the future of behavioral healthcare
Our field is rapidly evolving. The robots and algorithms aren't coming, they're here, but that doesn't mean you should fear for your job, though existential fear seems warranted. Life is about change; our field must adapt to new interventions and technologies. Since the beginning of Green Hill, I’ve thought extensively about the “future of healthcare” and its major themes. I predict that the next generation of leading behavioral health organizations will be masters of four things: (1) creating community, (2) collecting, analyzing, and managing data, (3) addressing social determinants of health, and (4) reframing healthcare from the reduction of suffering to the maximization of flourishing.
community
We are social primates. Let that sink in. So much of the modern world is defined by dehumanization, but our shared humanity is at the heart of our profession. Understanding this (we are social primates) is increasingly important as the world looks to technology to solve our problems. While much of adapting to the future involves navigating and adopting new technologies, creating a sense of belonging and cultivating community cannot be overlooked.
When the world shut down due to covid-19, a new wave of digital “innovations” promised to change behavioral health forever. I put innovation in quotes for a reason–providing therapy and psychiatry over Zoom is hardly an innovation if you ask me. Even as digital-first behavioral health organizations proliferated, I didn’t think it could last. The flexibility to work remotely is great, but I never believed that we would always prefer to work from the confines of our homes.
Unity is one of our core values, and the descriptor reads, “Human connection fosters well-being. We cultivate meaningful relationships.” When we wrote our core values, we wanted them applicable to our patients and providers. Behavioral health organizations that are most effective will be hybrid, not just in-person or digital. Providers often work in near isolation with their patients, which doesn’t serve to foster a strong internal culture. I believe that building a strong internal culture is imperative if we are going to be leaders in the field. While we know the importance of community when helping our patients navigate growth and recovery, we can’t overlook it in our own ranks. The best behavioral health organizations will create a sense of community for both patients and providers.
data
We collect data in a plethora of ways–from patient self-report to wearable technology. I’m not going to spend a ton of time on the importance of data, knowing that mentioning that word often causes eyes to glaze over; however, effective behavioral health organizations effectively collect, communicate, and share information (see what I did there?).
Alright, on to the doom and gloom aspect of my hypothesis. I think we’ve already crossed the threshold regarding artificial intelligence (AI) and machine learning (ML). Machines are infinitely more powerful than we are, and it’s not a failure to recognize that fact. My wife shared a meme with me last night: "Remember when they said we needed to learn math because we wouldn’t always have a calculator with us? We showed them.”
We must learn to work with technology, not against it. AI is going to trump clinical insight overnight. In fact it may mean quite the opposite. We will have more information at our fingertips than ever, and sound judgment will be more important than ever. Here’s a great, short read on some promising developments in healthcare-specific AI, transforming everything from prior authorizations and appeals to clinical documentation to reading imagery.
Let’s not be the last people selling typewriters (unironically). Leaders in behavioral health must skillfully collect, analyze, and communicate information. The best organizations will leverage cutting-edge technology and the data it produces to do what only we can: build community.
social determinants of health (SDoH)
Integrated care has typically focused on marrying mental and behavioral health with phsyical health. What is often overlooked and arguably the most critical aspect of healthcare are the social determinants of health (SDoH). SDoH are the conditions in which people are born, live, work, and age. These factors have an outsized impact on health outcomes, as the name (social determinants) suggests. Common SDoH include income, education, housing, transportation, employment, social support, and access to healthcare. Wow, that’s a daunting list of issues to address (or job security, as I read it).
I don’t want to bring politics into work. However, I believe that we have a living, evolving constitution; with that, what we deem as rights will change over time. I’ll stop short of saying that healthcare and housing are rights (they should be, IMHO), but I will say that we will continue to do our best to provide access to healthcare and supported housing and assist our patients with other SDoH. Addressing SDoH isn’t a pipedream, as this article demonstrates that California looks to spend some Medicaid money on housing.
I could go on and on about the importance of addressing SDoH, as it’s one of the most important way we can positively affect people’s lives while also lowering overall healthcare spending.
increase flourishing > decrease suffering
Does everyone know that I’m fond of the Greek word eudaimonia? If you weren’t, now you are. Possibly the most important messaging that “big healthcare” could do is reframing healthcare from a game of symptom reduction to human optimization. Most people don’t look forward to going to their dentist or PCP, but I think they should. Well, maybe not the dentist, Teresa’s candy bowl leaves me with eternal dread of the dentist. I digressed.
The best behavioral healthcare organizations of the future will work collaboratively with patients to optimize their lives, not just reduce suffering. I want to think that everyone will have a primary mental health care provider, much like they have a primary care provider. I first shared this notion, and where I got it from, over a year ago. “In 10 years, most of the population will be on board with this notion. Just as most adults have a primary care provider, they’ll have a primary mental health care provider. Mental Healthcare in 2032 ‘In 2032, people will view mental health with as much importance as their cardiovascular health. Just like (I hope) everyone has a PCP, everyone will have a PMCP.’”
in sum
Seeing that I’m already a few days behind schedule, I’ll spare y’all additional pontification. The field is evolving and creating a compelling vision for the “future of healthcare” seriously. Integrating new technologies, building community, addressing social determinants of health, and reframing behavioral healthcare is what great organizations in our field will be known for.
