Suicide is the 11th leading cause of death in the U.S. With such high prevalence, healthcare providers and governments face increased pressure to innovate and improve existing crisis response processes. During this Suicide Prevention Month, it’s important to uplift the recent shifts in policy and research that are paving the way for more targeted, impactful prevention strategies. By highlighting these advancements, we aim to raise awareness of the crucial efforts underway — from bolstering mental health services to improving post-crisis care — that can help save lives and provide communities with the tools to address suicide more effectively.

Evolving Regulations and Reporting

• Addressing youth needs: A recent JAMA Network study on preteen suicide prevalence indicated a significant increase in suicide rates across all demographics beginning in 2008, with an annual rise of 8.2%. In 2024 alone, 13% of teenagers reported suicidal ideation, with the highest rates among Native Hawaiian/Pacific Islander and multiracial youth. One in five youth had a major depressive episode, and over half did not receive treatment. In response to this need, senators Laphonza Butler (D-CA) and Lisa Murkowski (R-AK) have introduced two mental health bills: The Strengthening Supports for Youth Act and The Prevention Services for Youth Act. These bills aim to enhance family and peer-focused mental health supports and prevention services for youth, addressing mental health and substance use challenges among children, adolescents and young adults.
• Improving follow-up: A new study from Joint Commission Journal on Quality and Patient Safety about Evaluating the Prevalence of Four Recommended Practices for Suicide Prevention Following Hospital Discharge revealed a significant gap in implementation of recommended practices related to prevention of suicide post discharge. The study highlighted an opportunity for more providers to leverage post-discharge interventions such as safety planning prior to release or follow-up processes to improve care outcomes. One way to support greater post-discharge interventions is through real-time patient alerting software that could provide alerts to primary care providers when an individual arrives at an emergency department or behavioral health clinic for suicidal ideation or attempts. Such alerting systems allow providers to have greater patient insight and establish follow-up support programs so that the individual can remain in the continuum of care until recovered.
• Improving outreach: The 988 Suicide and Crisis Lifeline also remains an important resource to reduce suicide prevalence. 988 has responded to 10.8 million contacts since July 2022, with monthly interactions exceeding 500,000 as of May 2024, marking significant increases from previous years. Nationally, answer rates improved and wait times decreased despite higher demand, though some progress faltered in the second year. State-level variations in call volume and answer rates are notable, with monthly increases ranging from 25% to 185% and answer rates between 64% and 97%. Ten states have introduced telecom fees to support local call centers, addressing the surge in demand. Policy developments include potential geo-routing adjustments, expanded mobile crisis services, enhanced infrastructure for integrating 988 with other emergency services and growth in specialized services.

These trends underscore the need for comprehensive solutions, combining regulatory advancements, technology and community-based interventions to save lives and address suicide risk more effectively. For more information, contact us.

Access to timely behavioral health services remains a pressing public health concern. In the last reporting year, there have been over 100,000 overdose deaths, including those related to fentanyl and other opioids and 50,000 suicides. Additionally, emergency departments have seen over 200,000 non-fatal overdose-related visits. These figures underscore the critical need for interventions that can make a difference for individuals at risk.

In Aug. 2024, Bamboo Health took part in the Medicaid Enterprise Systems Conference (MESC) 2024 conference in Louisville, KY, which centered on Medicaid systems and related health policy. Experts from the Delaware Division of Substance Abuse and Mental Health (DSAMH) and Bamboo Health led an educational panel at MESC to discuss how to improve access to behavioral health crisis support services.

The panel featured Michelle Singletary-Twyman, Deputy Director at DSAMH; Sean Miller, State Account Director at Bamboo Health; and Vatsala Kapur, Vice President of External Affairs at Bamboo Health.

We sat down with the MESC panelists to learn more about their key takeaways from presentations, conversations and more.

Q: What is the current state of patients’ behavioral health needs? What policies or actions are in place to address crises?

A: States have an important opportunity to leverage Section 1115 Waivers to implement innovative strategies that address behavioral health crises more effectively. These waivers allow states like Delaware, California, Oklahoma, Montana and others to develop and test new approaches to care that could significantly enhance the support provided to at-risk individuals. While many innovative strategies are in place to expand behavioral healthcare access, here are some of the ways states utilize funding from Section 1115 Waivers:

• Track behavioral health facility bed availability to streamline 988 Lifeline response
• Reimburse services for serious mental illness
• Provide housing assistance and re-entry services for justice-involved populations
• Break down data silos to gain better insight into patient context across state lines

Q: Let’s take a deeper look at how Delaware approaches this challenge. How can other states improve crisis management?

A: Delaware has made significant strides in improving its crisis management program, offering a model that other states can emulate. The state has developed a comprehensive crisis care continuum bolstered by the implementation of modernized data tracking and referral systems. We call this the Bamboo Intelligence Hub™, or in Delaware, DTRN360. A core element of this solution suite is transforming behavioral health referrals, allowing state providers to seamlessly manage treatment referrals, track controlled substance information and gain insight into a patient’s entire care history, including admissions with other healthcare providers. A critical step in making this transformation has entailed  the shift from outdated paper and Excel chart documentation to an advanced crisis management system integrated through Bamboo. This system allows for real-time tracking of client encounters, ensuring that all interactions with individuals seeking crisis services are documented. This documentation is vital as it supports the building of a robust crisis care continuum and enables the effective management of data points that can influence client care.

Q: How can digital crisis management systems be used to better serve vulnerable populations, such as the uninsured, Medicaid patients or those who are justice-involved?

A: Alert features in crisis management software can help ensure no one falls through the cracks, providing greater visibility into patients’ needs and histories that historically may have been siloed. An example of this is the crisis system’s ability to support justice-involved individuals through their care journey. The system can alert care managers when a client has been arrested or released, providing critical information to maintain continuity of care. The system can also help bring in and support more uninsured individuals, a population that often goes unnoticed .  With features like a referral network that spans from emergency departments to psychiatric hospitals and recovery housing, the system helps streamline the continuum of care, reducing delays and improving access to necessary services for individuals  experiencing a physical or behavioral health disorder.

Q: How do data silos impact care delivery, and what role does collaboration with stakeholders nationwide play in overcoming these challenges?

A: Data silos are a significant challenge in the healthcare industry, particularly in behavioral health, where many systems still rely heavily on paper records or lack fully integrated electronic health records. This fragmentation hinders the ability to share critical information across providers, which in turn impacts care delivery. State health departments, behavioral and physical health providers and health plans need timelier patient context to make decisions and leverage a more cohesive and effective care delivery system, not just in Delaware but across other states as well.

The goal is to ensure that providers have the information they need to deliver the best possible care to their patients during pivotal care moments, no matter where they are in their treatment journey.

For Delaware, we discovered that many of our clients were receiving care outside of Delaware, in states like California and Texas—information we previously had no way of knowing. This data sharing is made possible through our collaboration with the Bamboo network, which connects us to hospitals and providers across the country. This nationwide data exchange ensures that we’re always aware of our clients’ whereabouts and care needs, no matter where they are. It’s a powerful tool for improving continuity of care and ensuring that our clients receive the support they need, wherever they may be.

Q: Recognizing behavioral health staff often face risk of burnout due to the nature of their caseloads, how can we better address administrative burden?

A: To alleviate this burden, it’s essential to streamline access to patient information and reduce the time spent on manual processes. One of the primary challenges in behavioral health is that staff frequently do not have the necessary information about patients readily available when they seek treatment. This lack of easy access to critical data can significantly slow down the process of connecting patients with the best possible care. Our goal is to address this by integrating more efficient data-sharing mechanisms so that staff can quickly access patient information and focus on delivering care at the top of their license rather than chasing down records.

We’ve found that having champions both at the state level and within the community is crucial to the success of technology implementations. These champions help drive the adoption of new systems by demonstrating their value to others. Early on, we organized user group sessions where different teams could share their experiences and learn from each other. This community-driven approach ensures that the tools we implement have buy-in and engagement from providers.

If you missed us at MESC this year, contact us to continue this discussion or meet us at an upcoming event.

In one calendar year, more than 109,000 people in the U.S. died from drug-involved overdoses, including illicit drugs and prescription opioids. According to the World Health Organization, nearly “80% of these deaths are related to opioids, with about 25% of those deaths caused by opioid overdose.” Overdoses and substance use disorder (SUD) can impact anyone at any time of life, underscoring the need for continuous vigilance and action across our healthcare system.

As overdose rates remain high, we recognize the important efforts of healthcare organizations nationwide in turning the tide. International Overdose Awareness Day (Aug. 31) and National Opioid Awareness Day (Sept. 21) are important moments to reflect and explore additional avenues for addressing this ongoing SUD crisis.

Integrated Care Opportunities to Turn the Tide on High Rates of SUD

While many healthcare organizations already support this important reduction of SUD’s prevalence and severity, individuals may still experience complex care pathways when experiencing behavioral health concerns. We’ll examine two key models that enhance integrated care and explore how the right tools can lead to improved health outcomes.

#1: The Certified Community Behavioral Health Clinic (CCBHC) Model

By providing integrated care and substance use disorder (SUD) treatment, CCBHCs offer pathways to coordinate care to support long-term recovery and, ultimately, reduce opioid dependency, offering a whole-person care approach to substance use management.

CCBHCs represent one example of how stronger behavioral health financial incentives can be a step in the right direction toward value-based care. Given that CCBHCs are incentivized to connect individuals to behavioral health clinics, they are uniquely positioned to improve individuals’ outcomes (especially when it comes to SUD) while reducing costs.

As the shift toward CCBHCs continues (with ten new states joining the Medicaid CCBHC demonstration in 2024), hundreds of provider organizations and community health clinics will need solutions and state funding to support the shift to greater care coordination and care integration. There is a wide range of tools available, but states making the move to CCBHCs can partner with technology organizations that can provide:

• Existing tools in the market that can be easily integrated, rather than needing to build whole care integration programs from scratch and “reinvent the wheel”
• Data feeds from both physical and behavioral healthcare providers that may not exist in their EHR systems today
• Actionable health context and tracking of individuals through the different facets of our healthcare continuum – from primary care doctors to behavioral health clinics.
• Solutions already compliant with CCBHC initiatives out of the box
• Ability to collaborate with a person’s care network.

According to the National Council’s 2022 CCBHC impact report, CCBHCs are already engaging in numerous activities to coordinate and integrate care, from electronic information sharing with care coordination partners (94% currently do this or plan to) to co-locating physical health services on-site (88% currently do this or plan to).

#2: The Sequential Intercept Model (SIM)

The second critical model exists in the justice-involved space, an important area for innovation given the high risk of overdoses, death and high recidivism. According to The New York State Office of Addiction Services and Supports, SUD has a correlation with criminality, and individuals “with criminal justice involvement currently account for 47% of all treatment admissions.”

The Sequential Intercept Model (SIM) offers an opportunity to improve visibility into gaps in care. The SIM demonstrates common care journeys for individuals with SUD and serious mental illness as they encounter and move through the criminal justice system.

As organizations seek to engage with and utilize the SIM to identify strategies for justice system diversion and treatment, providers and government agencies can partner with organizations that provide:

• Visibility into both individual health history and incarceration data
• Integrated tools via a ‘toolbelt’ approach that allows for care coordinators and providers to engage in relationships with justice-involved individuals
• Alerting platform to connect individuals to care and improve outcomes
• Post-incarceration pathway to wellness planning

Saving Lives

According to the CDC, 65% of drug overdose deaths had at least one potential opportunity for intervention in 2022, meaning an estimated 70,850 individuals could have been saved. Even one life saved is critical.

The time for action is now. Throughout opioid and overdose awareness days in August and September, we encourage healthcare organizations to continue forging collaborative partnerships across the healthcare continuum and investing in real-time technology solutions and services for more integrated care and better outcomes.

To learn more, contact us