Like the rest of the country, Utah has been facing a worsening behavioral health crisis. The state ranks 10th for the prevalence of anxiety in children aged 3-17 (12%) and 11th for adults with any mental illness (25.3%), according to data from the U.S. Department of Health and Human Services and the Center for Behavioral Health Statistics and Quality.
For parents with children under the age of three, Health and Human Services datalisted Utah as the highest in terms of mothers reporting fair or poor mental health (7.5%) and second highest in terms of parents reporting coping somewhat well or not well at all with the daily demands of raising children (47.9%).
To address this crisis, the Utah Behavioral Health Coalition, made up of health leaders and experts across the state, came together to develop a Behavioral Health Assessment & Master Plan that could serve as a guide for improving behavioral health systems.
Barriers to access
Before a plan could be formed, the coalition conducted an environmental scan to understand problems such as the barriers and inequities related to providing and accessing behavioral health services in Utah.
According to the 2020-2021 National Survey of Children’s Health data query, 58% of children with a clinically diagnosed mental or behavioral health condition didn’t receive treatment or counseling. Nearly half of adults in Utah with mental illness also aren’t receiving treatment.
What is preventing access? Some of it is lack of education on the consumer side.
“We have a lot of good service in the state, but people don't know about it,” said Ross Van Vranken, outgoing executive director of the Huntsman Mental Health Institute.
There are also system-level issues. The coalition’s master plan highlighted five interconnected challenges: lack of system-level coordination, administrative burden, siloed systems, low funding and workforce shortages. The plan says these affect and worsen each other and lead to limited access to care.
The cost
Mental and behavioral health can have devastating and lifelong consequences for Utahns and their loved ones. According to an analysis by the Kem C. Gardner Policy Institute and the Utah Hospital Association, suicide is the leading cause of death for Utahns ages 10-24. The Utah suicide rate has also been consistently rising for decades.
According to the Mayo Clinic, untreated mental illness can cause severe emotional, behavioral and physical health problems. It's also associated with an increased risk of substance abuse, poverty, issues with work or school and relationship difficulties.
On top of personal consequences, behavioral health has a large monetary cost. According to a paper with the National Academies Press, mental, emotional and behavioral disorders among youth cost $247 billion per year nationally in health services, lost productivity and crime.
The master plan
After conducting the environmental scan and assessing system-level gaps and key areas of need, the Utah Behavioral Health Coalition created a master plan to serve as a guide for private and public sectors, systems and stakeholders.
Along with four overarching values of equity, value, alignment and access, the master plan includes seven strategic priorities:
- Support continued use, implementation, creation and innovation of evidence-based interventions
- Strengthen behavioral health prevention and early health intervention
- Integrate physical and behavioral health
- Improve patient, family and consumer navigation
- Continue to build out Utah’s behavioral health crisis and stabilization systems
- Improve the availability of services and supports for individuals with serious mental illness and complex behavioral health needs and their families
- Expand, support and diversify Utah’s behavioral health workforce
Each strategic priority has in-depth key starting points, next steps and future areas to address.
The plan also notes behavioral health disparities such as among Black, Indigenous and other communities of color, the LGBTQ+ community, those experiencing homelessness and people with developmental disabilities.
Tammer Attallah, executive clinical director of the Behavioral Health Clinical Program with Intermountain Health, emphasized the importance of involving both public and private entities, especially because most Utahns have private health care coverage.
“Self-funded commercial plans as well as commercial plans, that represents 57% of the need. So, ensuring that we’re trying to serve all Utahns, to be thinking about this work from a public/private perspective is really, really essential,” Attallah said.
The silver lining
Though the master plan mostly focused on issues and needed solutions to solve them, it also said there are many positives to recognize.
The plan said Utah’s leaders and behavioral health providers have shown understanding of the importance of addressing these issues, and noted a growing number of sectors and stakeholders are also becoming invested in improving Utahns’ behavioral health.
Utah is also leading the nation on many behavioral health innovation and reforms, such as SafeUT, the 988 crisis line and Utah’s comprehensive crisis system.
“What’s exciting is the commitment of so many different groups that usually fight each other for the people of Utah and trying to come together and put together a unique plan,” said Mark Rapaport, MD, CEO of the Huntsman Mental Health Institute. “I think the state and all of the various parties within the state should be commended for what they’ve done.”
Next steps
The coalition has also worked with Utah Senate Majority Leader Evan Vickers to draft S.B. 27 for the upcoming legislative session, which would create a Utah Behavioral Health Commission to bring together and consolidate organizations for efficiency.
“We have lots of silos. We've identified an awful lot of them, over 40 different groups,” Vickers said. “So our job’s to try to figure out, okay, how can we do a better job of centralizing that and bringing together an umbrella organization.”
If S.B. 27 passes, the Utah Behavioral Health Commission will be in charge of continuing to update and encourage implementation of the master plan.
Making change takes time, but the coalition is hopeful for the future of Utahns’ health if public and private entities put in that time.
“[In five to seven years], I think they'll have better access to treatment, I think they'll have better care when they access treatment,” said Brandon Hatch, CEO of Davis Behavioral Health. “I think people will be healthier, and hopefully we will see suicide rates go down and the availability of access to services go up.”
