The past 20 months have thrown into sharp relief many longstanding and systemic challenges in behavioral health systems across states. The spike in demand during the COVID-19 pandemic, coupled with diminished provider capacity, further challenged access to care and accelerated calls to modernize strained and under-resourced public behavioral health systems. Medicaid enrollees and other low-income individuals were hardest hit, and while other health service use has reached pre-pandemic levels, mental health service uptake has been the slowest to rebound. Leaders at all levels of government and across politically diverse states are seeking to expand access to behavioral health services and supports. States play a central role in shaping these systems to meet the unique needs of their residents and can capitalize on renewed federal investment and the evolving policy landscape to make real improvements, and state policymakers are keen on taking the many lessons learned from recent experience and approaching behavioral health modernization with a fresh lens.

To support state leaders in these efforts, the National Academy for State Health Policy (NASHP), with support from the Commonwealth Fund, is launching a new project focused on building state capacity to strategically modernize and improve behavioral health systems. The project will include development of a framework for state behavioral health system transformations geared toward needs of children, youth or adults (under age 65) at-risk for or identified as in need of services and supports. and a 12-month, multi-state learning collaborative built around those lessons. The learning collaborative will include up to five states to exchange strategies, best practices and provides opportunities to learn from national, state and local experts about effective and promising approaches.

The Behavioral Health Modernization Learning Collaborative will help states advance their own project-specific goals — for children, youth or adults (under age 65) who are at-risk for or in need of behavioral health services and supports — by offering strategies for improving and modernizing state behavioral health systems in one or more of the following domains:

• Increasing access to integrated care
  • Including state policy, payment and delivery approaches and strategies to incentivize evidence-based and best practices;
  • Workforce and provider capacity building approaches
• Building the community-based continuum of care
  • Including: cross-sector alignment and braided funding approaches (across Medicaid, behavioral health and human services programs)
  • Assessing and building the crisis response continuum and linkage to community-based services and recovery supports

Next Steps

NASHP’s forthcoming behavioral health modernization framework and learning collaborative is poised to support states in bolstering and transforming their behavioral health systems for children, youth or adults (under age 65) at-risk for or identified as in need of services and supports. NASHP will select up to five states teams through a competitive process to participate in a 12-month learning collaborative, featuring multi-state and individual technical assistance, through convenings, regular technical assistance calls and ongoing connection to subject matter experts. Teams will be comprised of decision makers in behavioral health, Medicaid, other health and human services officials, and other state officials as indicated (e.g., budget officers, data leads, etc).