The Shift Toward Extended Mental Health Care
For too long, the mental health system has operated on a crisis-management model. As noted by Doris Moore, founder and CEO of the Center for Holistic Development, insurance guidelines often dictate the length of stay in care facilities. For those experiencing suicidal ideation, this may be as little as three days before they are transitioned to community therapists.
The future of behavioral health must move toward extended care models. Many individuals with challenging conditions require “extra care” to ensure they remain stable and adhere to necessary medications. Without this extended support, patients are prone to spiraling downward once they leave the clinical environment.
Decarcerating Mental Health: Beyond the Jail Cell
A troubling trend in the metro area is the reliance on correctional facilities to house those in psychiatric distress. In Douglas County, approximately 50% of the jail population suffers from some form of mental health issue.
The trend is now shifting toward integrating specialized care within and adjacent to the justice system. By building true mental health facilities rather than utilizing jail cells, the goal is to ensure that no one has to enter the criminal justice system simply to receive psychiatric services.
This evolution in care aims to prevent the “downward spiral” that occurs when individuals on outpatient services stop taking their medication and finish up on the streets or in custody.
The Rise of Culturally Specific Behavioral Health
Generic mental health services often fail to address the specific needs of diverse populations. There is a growing recognition of the need for diversity in mental health positions and services, particularly for the BIPOC community.
The Center for Holistic Development was established specifically to fill a void in Omaha, addressing the needs of the African American community in North Omaha. This approach acknowledges that historical trauma and systemic racism are traumas in themselves that require specialized, culturally competent care.
Navigating the Financial Hurdles of Community Care
While community-based facilities are expanding—such as the $20 million project near the Douglas County Health Center—financial restrictions remain a significant barrier to scaling these services.
A critical challenge is the Medicaid reimbursement limit. Under National Institute for Mental Disease guidelines, facilities are often limited to 16 beds to collect Medicaid. These restrictions have historically contributed to the shutdown of regional centers, leaving a gap in the availability of long-term care beds.
Future trends suggest a need for legislative advocacy to fight funding cuts and Medicaid restrictions, alongside efforts to dismantle the social stigma that continues to hinder mental health progress.
For more on how these gaps impact the community, read about the lack of healthcare facilities in the Omaha area.
Frequently Asked Questions
Why are there so few beds in community mental health facilities?
Financial restrictions, specifically Medicaid laws, often limit facilities to 16 beds to remain eligible for reimbursement, which limits the number of people the county can help.
How long do insurance companies typically allow for crisis stabilization?
In cases of suicidal ideation, insurance may only allow a stay of about three days before the patient is expected to connect with a community therapist.
Why is culturally specific care important in mental health?
Culturally specific services, like those provided to the BIPOC community, address unique historical traumas and racism that general services may overlook, making care more effective and accessible.
Worth a look