Changing the Conversation About Behavioral Health Spending

By Sandy K. Johnson

Only about 4 percent of health spending in the United States goes toward behavioral health. The rest goes to pharmaceuticals and medical care.

Why does this matter? Because 40 percent of premature deaths are caused by behavior, whether it’s smoking, drug use, obesity or mental illness, according to Arthur C. Evans Jr., CEO of the American Psychological Association.

In a presentation at the National Press Foundation, Evans said, “We’re never going to bend the cost curve in health costs” until there is effective treatment for behavioral health.

“Our whole system for dealing with mental health and substance abuse is very passive. Only 10 percent of people who are ill seek out treatment,” he said.

Government spending is a critical component of the $179 billion that is spent on mental health. Of that, 29 percent comes from Medicaid and 14 percent from Medicare, the twin pillars of taxpayer-funded health care. For comparison, private insurance covers 26 percent.

Before moving to the APA, Evans was commissioner of Philadelphia’s Department of Behavioral Health and Intellectual disAbility. He is proud of incorporating behavioral services across the city – in schools, jails, courts, child welfare agencies and libraries.

At public events, his agency would set up tables offering free mental health screenings right next to blood pressure screenings. “Doing work in that very public way gives people permission to reach out,” Evans said.

He said engaging the community works. As an example, he cited Philadelphia’s “recovery walk,” which drew 150 people 15 years ago; last year, 26,000 people walked. “It’s a good reflection of how public attitudes can change,” he said.

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