"Our coastline in central California is doing quite well, and Los Angeles is doing quite well, but we've got some unique challenges in California," she says, citing a 2012 CHA study that showed a 47% increase in individuals presenting at the state's ED with a behavioral health diagnosis between 2006 and 2011.
The pressure on EDs to treat more and more psychiatric patients began almost a decade ago, but now, with the new mental health benefits granted to patients because of the Patient Protection and Affordable Care Act, access, or lack of access, is likely to become a heightened pain point this year.
Behavioral and mental health services are considered one of the 10 essential benefits that health insurance companies must offer in order to participate in the health insurance exchanges. As of this week, the Centers for Medicare & Medicaid Services announced that 4 million individuals had signed up for insurance on the exchanges nationwide.
Not much is known about this population yet, but since the exchanges were set up to insure people who didn't have access to insurance previously, it is a safe assumption that there will be an initial increase in utilization rates says Alan Whitters, MD, director of behavioral services at Mercy Medical Center in Cedar Rapids, Iowa.