Fixing Mental Healthcare in America

Fixing Mental Healthcare in America

An interview with Dr. Nicole Eberhart and Dr. Ryan McBain from the RAND Corporation. Curt and Katie kick of their special series related to the problems and potential solutions in the mental healthcare system. We interview Drs. Eberhart and McBain about the study they authored related to the structural concerns in the mental health system as it is currently built and their recommendations for solutions and best practices going forward.

Nicole Eberhart, PhD is a Senior Behavioral Scientist at the RAND Corporation and a licensed clinical psychologist whose research and evaluation focuses on mental health. She has expertise in health program evaluation, prevention and early intervention, health services and systems, and innovative care models including those that integrate primary and behavioral health care. Dr. Eberhart been evaluating mental health programs and policies in California and nationally for over a decade.

Ryan K. McBain is a policy researcher at the RAND Corporation. He focuses on the design and evaluation of health policies and programs meant to reach vulnerable populations—including those coping with mental health conditions, HIV/AIDS, homelessness, and poverty. To achieve this, McBain has utilized a wide range of methodologies, including econometric approaches for quasi-experimental analysis, cost-effectiveness analysis, and decision analytic models, as well as key informant interviews and focus group discussions. Internationally, McBain has worked with the World Bank, World Health Organization, Harvard University and Partners In Health, where he has focused on evaluating mental health, HIV, and primary care service delivery systems, primarily in sub-Saharan Africa and Haiti. McBain holds a Ph.D. and M.P.H. in global health with concentrations in health economics and health policy analysis from Harvard University, as well as a B.A. in psychology from Gordon College and Oxford University in the United Kingdom.

In this episode we talk about:

• Introducing our new series on Fixing Mental Healthcare in America
• RAND corporation report on the mental health system
• Structural issues in the current mental health system
• Work force issues, lack of professionals, poor distribution across communities
• Payment issues – Mental Health providers are not paid as well as other medical providers
• The problem of fee for service, government insurance programs, and private pay
• Culture problem – historical lack of value of mental health, stigma and de-prioritization of mental health
• Lack of educational programs for mental health, lack of consistent, effective crisis response
• The idea of increasing wages for entry level positions
• Peer Support Specialists as another way to expand mental health workforce
• The importance of lived experience and the professionalization of the peer support specialist profession (for example certification)
• The idea of paying for value rather than paying for services
• Focusing on prevention rather than costly emergency services
• The need for legislators to make changes
• The costs of not fixing the mental healthcare system
• An evidence-based continuum of care
• Taking a big picture approach (looking at the cost for services and the cost for society)