Page 17 - July Aug 2022 Newsletter Final_Neat

Continued from page 16 can help promote healthy lifestyle modifications in the whole family system (5)

As policies are being undertaken to address these challenges at the ground level, the shortage of community-based
healthcare workers remains an issue. The community based mental health workers are usually employed at commu-
nity clinics funded through government programs; however, their availability is scarce in the private sector. Families
that may be more likely to be impacted by the lack of these resources are those who do not qualify for government-
funded programs (such as Medi-Cal in CA), and those who cannot afford out-of-pocket costs for these services.
Commercial health insurances, whether individual or employer-sponsored, do not usually reimburse for case man-
agement or family support services, in a preventative manner, on an outpatient basis.
Other systemic barriers such as health insurance requiring diagnoses, to cover services that are based on "medically
necessary” care, can be prohibitive in terms of supporting early interventions. In addition, there has been a shift in
the current psychiatric healthcare model to curb the reduced access to care by primarily increasing prescription-
based psychiatric interventions. While this strategy may be well-intended, it may also be leading toward a reduction-
ist model of mental health care along with creating further gaps and a shortage of workforce at the community-based
level of care (6). The strategies focused solely on providing care at the secondary or tertiary level of prevention also
tend to escalate healthcare costs.
As the mental health of a child is entrenched in the health of a family and community, the multi-pronged approach,
which favors the integration of community-based efforts to increase the overall well-being, needs to be further recog-
nized. The biopsychosocial approach is at the root of each psychiatric case formulation, yet the resources and work-
ers needed to address an individual’s social and family environment are lacking. Policies directed towards increasing
the workforce incentives including increasing reimbursement rates through public health insurance and requiring
private health insurance to cover community-based work may be a step toward filling the gaps in children’s mental
well-being.
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NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 17 July/August 2022