Op-Ed

Behavioral health services need legislative action

Dr. Dan Krebs is a family physician at the Eastside Tanbara Clinic in Tacoma and is the assistant medical director of Community Health Care.
Dr. Dan Krebs is a family physician at the Eastside Tanbara Clinic in Tacoma and is the assistant medical director of Community Health Care.

Our community is in the midst of a behavioral health crisis.

From my vantage point as a family doctor and assistant medical director at a busy community clinic on the eastside of Tacoma, every week I see patients who struggle with uncontrolled serious chronic medical conditions, including diabetes, emphysema, heart disease and chronic kidney disease.

I can offer excellent low-cost medications, testing and other treatments for these conditions. However, all of these chronic illnesses have a strong behavioral component to them – our habits, feelings and mental state have a profound effect on our ability to control things like blood sugar and blood pressure.

Unfortunately, our community’s existing behavioral health services are not integrated with primary care. Even if I refer these patients to our existing behavioral health silos, only about 2 out of 10 patients will actually make it to these consultants. As a result, every day we see patients who have escalated to crisis level services, needing emergency room visits and hospitalizations, in some cases as many as 80 times within a single year.

Not only does this broken system pose significant risks for the patient’s health, it is also extremely costly to the taxpayer.

The good news for our region is that our legislators have the opportunity to correct this situation by funding two strategic priorities during this legislative session. The first is to fund a $3.5 million investment in three key regions, one being Pierce County, to achieve behavioral health integration by 2017 – three years ahead of the statewide goal for integration.

This money would be used to bring much needed behavioral health services right to the point of primary care, where my colleagues and I can work to prevent behavioral health crises before they happen. The lessons from these earlier regions would be applied to the statewide rollout.

However, the workforce required to meet this need is in short supply. In order for behavioral health to become integrated with primary care, we need to attract, train and retain enough nonprescribing licensed behavioral health specialists, including psychologists, marriage and family therapists and social workers.

Currently, only certain types of health-care clinicians are eligible for loan repayment programs, which are an important tool for recruiting providers to work with underserved populations. Therefore, the second legislative priority for integrating behavioral health must be to expand the Health Professional Loan Repayment Program to include social workers, therapists and psychologists.

We owe it to our family, friends and neighbors to prevent behavioral health crises before they happen. At Community Health Care, we have five clinics in Pierce County with 40 dedicated family practice clinicians ready and willing to care for our community’s most vulnerable patients. We’re proud to serve more than 30,000 patients a year. But we need legislative investment and expansion of loan repayment in order to ensure that we can put patient-centered behavioral health resources directly in that hands of front-line primary care clinicians.

Dan Krebs, M.D., is a family physician at the Eastside Tanbara Clinic in Tacoma and is the assistant medical director of Community Health Care. He resides in Tacoma.

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