Behavioral health access in Louisiana: Transforming community health systems for health equity

According to a 2005 SAMHSA survey, 5.7 million adults in the US reported an unmet need for mental health services, citing barriers such as lack of access to primary care providers, lack of practitioners in rural and urban areas, and lack of payment for care coordination with supportive services.  These barriers disproportionately impact vulnerable populations, particularly those who are uninsured or on Medicaid.  In 2014 health inequities persist in southeast Louisiana and lead to higher healthcare costs due to over-utilization of Emergency Departments and law enforcement resources, and decreased quality of life for individuals and their families.

In order to combat these barriers, the Louisiana Public Health Institute (LPHI) is engaged in transforming two geographically and demographically different safety-net behavioral health systems in Louisiana to increase access along the continuum of care.  Each system is led by a trans-disciplinary collaborative including health providers, law enforcement, and the school system, among others.  Howerver, there are noteworthy differences between the two communities and their approach to behavioral healthcare.  In order to understand these differences and drive redesign efforts, LPHI used a mixed methods approach to assess the current state of each health system.  Data from clinic capacity assessments, key informant interviews, quantitative patient data, and GIS mapping were analyzed, and will be presented to illustrate the cases for each re-design process.  This presentation will discuss the re-design approaches and share challenges, lessons learned, and recommendations for improving similar health systems to ensure equal access to quality care regardless of where you live.