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Last month, the Health Planning Council voted to approve the first section of the State Health Plan, which looks at behavioral health. The Health Planning Council was established by Chapter 224, a 2012 law that includes a variety of initiatives aimed at controlling health care costs. The Department of Public Health and the Health Planning Council have been tasked with looking at fifty-two different areas of health care. Behavioral health, which includes mental health and substance use disorder, was the first area tackled by the Department and the Council. Behavioral health is an extremely important aspect of the health care system, especially in light of the opioid epidemic and the high cost of behavioral health services.

Health planning generally looks at three areas: need, inventory, and capacity. Need pertains to the estimation of how many people could or should access a type of care. Conducting an inventory entails identifying and mapping the number and location of providers across the state. Finally, an analysis of capacity tries to determine how much care those providers are offering or could offer. By comparing need and capacity, the health plan can begin to consider where there is unmet need. The Behavioral Health plan breaks down the state into eight regions to enable the analysis to be conducted at a finer level.

Given the complexity of behavioral health, cooperation across state agencies was vital in data sharing and expert guidance in producing this first State Health Plan. The Department of Public Health’s Office of Health Policy and Planning worked closely the Secretary of the Executive Office of Health and Human Services along with DPH’s Bureau of Substance Abuse Services (BSAS) and the Department of Mental Health (DMH). Several key findings about behavioral health care emerged from the health planning process:

  • Only 17% of clinics integrate mental health and medical services according to their licensure data.
  • Statewide, the number of mental health beds per capita compares favorably to other states. However, only Metro Boston is above the 50 beds per 100,000 rate that is often considered a benchmark. The Central, South Coast, and Cape and Islands have the lowest rate of mental health beds per capita.
  • The regional bed density per capita for substance use treatment beds differs from mental health beds, with the Central and Cape and Islands regions having the highest density (for a population ages 13+).
  • Occupancy rates for mental health beds are at or just above 85%, which is generally considered full occupancy.

The plan made several recommendations about the behavioral health care system:

  • Improve the data collection and reporting for behavioral health services, especially for outpatient services.
  • Continue current interagency efforts to promote the integration of behavioral health and primary care.
  • Support a robust community system with the resources and capabilities that can keep people healthier, divert patients to lower levels of care when appropriate, and support patients are discharge from higher levels of care.

The Department also engaged providers, advocates, and the public during the planning process. A series of written surveys and in-person interviews with providers and experts informed the early stages of the process. Additionally, the Department conducted three public hearings across the Commonwealth in Springfield, Fall River, and Boston.  These sessions were attended by more than 100 providers, advocates, and consumers. Many public comments addressed barriers to access, stigma around behavioral health, problems in transitions between levels of care, and lack of integration between behavioral health and primary care.

The full plan, including all the analysis conducting during the health planning process and a fuller list of public feedback, can be found on the website of the Office of Health Policy and Planning: www.mass.gov/dph/ohpp.

Written By:


Associate Commissioner

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