Multisector Systems Analysis to Integrate Behavioral Health Policy: Successes and Challenges to Working Across Sectors (APHA 2016)


Fragmentation between health care delivery, public health, and community service systems represents a significant barrier to improving the health, well-being, and equity in our country. We propose to establish the “Action Research Center for a Culture of Health (ARCCOH): Financing and Service Delivery Integration.” The signature project of the ARCCOH will target the health care coordination of patients with mental illness and/or substance use disorders, also referred to as behavioral health disorders (BHDs). Nearly 25% of the general population in the US experiences some form of a diagnosable mental illness while un- and under-treated mental and behavioral disorders represent the biggest contributor to disease burden. The care fragmentation in health care services for BHDs is a striking example of overlapping financing mechanisms, conflicting policies and an institutionalization bias in our health care system. As a result, the healthcare system for individuals with BHDS in this country can be characterized by profound inequity, significant fragmentation, wasteful duplication, and a severe lack of coordination. This study investigates how multisector services, delivery systems, and financing streams are currently aligned as well as their gaps. Using multi-sector databases from hospitals, Medicaid, the law enforcement, the court system, and social service agencies, we simulate a future state of how they could be better aligned to create a coordinated delivery system for BHD with an improved impact on health, well-being and equity for the population. This is accomplished using a mixed-method approach to model interventions and predict outcomes at the systems level (including microsimulation, data visualization, Delphi simulation, financial modeling, causal models through structural equations and quasi-experimental designs). We then triangulate multisector evidence regarding alignment of the financing and delivery system. This study generates findings that promote innovation and transformational action at national, state and local levels.


Presentations (Oral or Poster)
Riley W