Allen Tien, MD, MHS; President and Chief Science Officer at mdlogix
Because our society has has not yet fully attended to the mental health and social needs of children, families, and adults, we now have an expanding opioid crisis that requires rapidly improving interventions across the life-course. As we allocate resources to address the acute needs of people with OUD – including expanding access to medication assisted treatment and the life-saving drug naloxone – our state and local governments should also plan to invest in treatment and prevention efforts that span gestation, neonates, early childhood, K-12, young adults, adults in the workforce, and elders at home.
Education is one of the most important preventive interventions, empowering individuals to manage their own health and the health of those they care about. We can begin by consciously shifting how we think about our health, incorporating tools to help translate this thinking into practice wherever we live, work, study, or receive care. We can drastically influence our risk of behavioral health problems and chronic physical conditions by learning how to prioritize sleep, social connection, exercise, gratitude, meditation, and a healthy diet. Though most people inherently recognize the benefits of these (mostly free) interventions, knowing is not half the battle. People need tools, strategies, and community collaboration to help turn these practices into lifelong habits.
School-based mental health programs offer another platform for early identification and intervention, and many of these efforts are supported by Medicaid offices who are working with state health and education departments. These programs offer resources to students and families struggling with mental or physical health conditions, fractured family relationships, adverse life events, and socioeconomic issues. They help to identify at-risk students and their families, connecting them to treatment and support in the school and within the community. Many programs are providing training to teachers and school staff to help them identify students experiencing suicide ideation, teaching them to perform basic interventions that can prevent crises.
Behavioral health measures and interventions should be integrated into all clinical care settings, particularly in primary care, emergency departments, pain centers, obstetrics departments, and Healthy Start clinics. These interventions should also coordinate with social support services to address factors that influence health outcomes such as access to adequate housing, nutritious food, transportation, employment, and education opportunities. Enhanced case management can support the most vulnerable patients, including prenatal or perinatal patients with SUD or mood disorders, patients in short or long-term SUD recovery, and patients with comorbid mental health and chronic physical conditions.
As a society, we’re beginning to identify the roots of the opioid crisis, and we’re now understanding the new seeds we need to plant to solve this complex problem. These initiatives will require a shift in the healthcare ecosystem, expanding its reach beyond traditional boundaries. Meaningful, accurate, and accessible data is critical to the sustainability of these treatment and prevention efforts. Successful programs will require data collection and workflow processes that enable collaboration across a vast network of state and federal agencies, providers, community-based organizations, and families.
