The role of psychiatric rehabilitation in the delivery of behavioral health services

The Recovery Workforce Summit: 2015 Annual Conference

Over the years we have tackled many issues around the philosophy and the technology of psychiatric rehabilitation, the development of the workforce and the impact psychiatric rehabilitation has on individual lives. We are now facing dramatic changes in the delivery of behavioral health services, and to meet those changes we must shift our focus to address the role psychiatric rehabilitation plays in a managed care environment. Systems with various managed care approaches, and administered by a large number of entities, have their own approach to care management and service authorization. It is a defining moment for the now mature psychiatric rehabilitation movement and a great opportunity to become leaders in the managed care environment.

This past June I had the opportunity to co-present a session at the Psychiatric Rehabilitation Association (PRA) Annual conference with my colleague John Kulesza, Director of Supportive Housing at the Collaborative Support Programs of New Jersey. In our session, we discussed some of the challenges of retaining focus on recovery and person-centered planning in this new era of managed care. In conversations around the country, and echoed in our session at PRA, one of the biggest fears I hear from community-based providers is a concern that with managed care, providers will lose their therapeutic partnership with the individual they are supporting and that they will be drawn into a more traditional patient-to-practitioner episodic care relationship. Although this is a possibility, there are strategies to help avoid such an outcome. These include establishing a culture of accountability and ensuring all regulatory requirements are met. Coupled with a person-centered approach to documentation and using concurrent documentation strategies, agencies can maintain a person-centered approach to recovery even in a managed care world.

For the new world of behavioral health service delivery to be successful, the psychiatric rehabilitation community must become a major component of every managed care environment. How will this happen? How can a psychiatric rehabilitation provider succeed in a world traditionally controlled by mental health institutions and standalone clinics? What can we offer as a community of providers that makes us unique and necessary? The answer is to continue doing what we do best: helping people regain their lives. We should provide services that meet the needs of the person rather than expect people to meet the needs of the program. We should capture the information that confirms what we already know–we help people stay healthy, reduce dependence on emergency care and decrease hospitalizations. We can use this information to show value to networks and managed care companies. We can also use this data to continually evolve programs, redefining how they meet the needs of customers. In summary, we should continue to develop treatment networks based on collaboration with support programs that build a silo-free experience for the individual.

I am confident that the skill level of staff that comprise the psychiatric rehabilitation community is strong and ready for our new era of managed care. Now it is time that organizations like the Psychiatric Rehabilitation Association and its affiliated state chapters help provide ongoing guidance and structure to rehabilitation providers so they can be even more successful players in the new world of behavioral health service delivery.