Mental health has received a considerable amount of attention in recent years, and the issue is becoming more commonly referred to as behavioral health, which encompasses mental health and behavioral choices that affect health. Celebrities are speaking out about the effects of depression, substance abuse, bipolar disorder and eating disorders, and individuals feel more comfortable addressing mental health among their peers.
Attitudes and treatment options are unclear. Dr. Sue Dahl Popolizio, ASU’s doctorate of behavioral health degree director and clinical associate professor at ASU’s College of Health Solutions, says there are many reasons mental health issues are not consistently addressed.
“The stigma of going to see a mental health therapist, the high cost of visits or co-pays, lack of mental health insurance coverage, cultural considerations, and lack of knowledge regarding what type of therapist to see – such as social worker, psychologist, marriage and family therapist, licensed professional counselor, substance abuse counselor, among others – are all factors that intimidate, or otherwise impede a person’s ability to have their mental health needs addressed,” she notes.
Thankfully, many professionals are working to provide more comprehensive care for patients. One strategy is to make behavioral health a focus of primary care practices rather than limiting it to specialty care. Doing so would help clinics uphold the Institute for Healthcare Improvement's Triple Aim, an initiative supported by the health care industry at large. This effort aims to:
- Improve the health of populations.
- Improve the patient experience, particularly concerning quality and satisfaction.
- Reduce the per-capita cost of health care.
To support the Triple Aim, existing and future medical and mental health providers will need a comprehensive understanding of what behavioral health is, how to treat behavioral concerns, how to consolidate these treatments into primary care practices and what will be the best ways to carry out policies and strategies that address the issues that often underlie the physical issues typically seen in primary care offices.
Working with a primary care team member who has a Doctor of Behavioral Health degree can help physicians overcome these challenges. Prospective students may choose to focus their degrees in either clinical practice or management. These concentrations are designed to prepare students from mental health, health care, and management backgrounds to pursue specific paths upon graduation that meet their professional goals.
What is behavioral health?
People often use the terms “behavioral health” and “mental health” interchangeably, but clinicians emphasize a distinct difference. While mental health refers to a variety of emotional and psychological disorders, behavioral health addresses these issues as well as focusing on how patients’ actions and environments contribute to their physical and emotional well-being.
“Behavioral health addresses mental health issues and behaviors that affect health and well-being, such as diet choices, adherence to medical instructions, smoking, substance use and abuse, activity levels and more,” says Dahl-Popolizio.
Factors that may influence behavioral health and more include:
- Chronic illnesses.
- Coping mechanisms.
- Eating habits.
- Home environment.
- Work environment.
Some influencing factors are outside the patient’s control. For example, a family living near a polluted water supply affecting their physical health may not have the resources to move. Similarly, individuals working in high-stress environments may be unable to leave their jobs. Other factors, such as addiction and substance abuse, require consistent effort, strong willpower and the help of a knowledgeable, supportive health care provider. With such a variety of circumstances affecting people, treating behavioral health issues requires individualized, nuanced approaches.
Current efforts to improve behavioral health services
With crises like the opioid epidemic dominating the news, medical professionals and the general public have given increased attention to behavioral health. The American Hospital Association and other health care groups have consistently called upon Congress to enact comprehensive mental health care reform that addresses these and other behavioral health issues.
Furthermore, advocates are campaigning for inclusive primary care treatment that includes mental and behavioral health, not just physical health. This would help by providing better mental and behavioral care for people who only have or can only afford a primary care physician, and it reduces stigmas surrounding mental and behavioral health disorders. By providing greater access to behavioral health care services, instances of opioid abuse, interpersonal violence and other prevalent social problems could begin to decrease.
Per the American Psychological Association, while approximately 1 in 4 primary care patients suffers from depression, primary care doctors address this disorder in only 31 percent of cases. Health care professionals believe integrating behavioral health into primary care can help reduce medical costs and provide better patient outcomes.
In general, behavioral health doctorate programs focus on clinical practice and advocacy. The coursework is designed to help practitioners support and carry out measures that integrate behavioral health and primary care. Those looking to study further may want to pursue a Doctor of Behavioral Health degree, and choose a management or clinical concentration depending on if they’re interested in clinical practice or planning to move into management.
Comparing behavioral health clinical and management doctoral programs
Two behavioral health concentrations – clinical and management – are designed to address separate yet related aspects of the current healthcare environment. Both cover core topics such as population-based health management and organization, delivery and economics of health care systems, quality and performance measurement, and health improvement and incentives. Either of these degrees can help to prepare graduates to work in integrated healthcare environments where clinical, operational, and financial policies, procedures, and practices are combined to support medical and behavioral health services. The concentration you choose depends on whether you prefer to focus on the management of an integrated care program, or provide/oversee clinical services.
Additionally, both programs are available online, allowing students to earn an advanced degree while managing their current professional commitments. The program differences, however, can better prepare students for the specific types of behavioral health careers they may wish to pursue.
A clinical concentration
This program is for students who are licensed or license eligible as medical, behavioral or allied health professionals and want to take a hands-on approach to behavioral health. Upon completion, clinicians will be prepared to employ evidence-based treatment programs while working directly with patients in a primary care setting or a behavioral health setting that provides primary care services.
“The clinical track ensures that providers approach their patients with a whole person lens, understanding the medical conditions and the commonly co-occurring behaviors, and behavioral health conditions that impede their health and well-being,” says Dr. Lesley Manson, ASU’s doctorate of behavioral health degree director and clinical associate professor.
Licensed and license-eligible clinicians who do not have direct experience or would like to enhance their clinical skills practicing as a behavioral consultant in a primary care setting are suited for a DBH clinical concentration.
Courses in the clinical concentration include:
- Brief interventions in primary care.
- Clinical medical pathophysiology (includes medical terminology).
- Clinical neuropathophysiology.
- Models of intervention.
This concentration is designed to prepare students for careers such as:
- Behavioral health consultant.
- Behavioral health provider.
- Clinical manager.
- Healthcare consultant.
- Health coach.
- Health educator.
A management concentration
This program is designed to train current and future health care managers for an evolving practice environment that incorporates behavioral interventions into primary care spaces. While clinicians deal directly with patients, managers enact the policies and create budgets that support these professionals and the patients in their care.
“The management track provides training in management skills that ensure integrated care programs are run effectively and efficiently, and meet the needs of patients, providers, and healthcare organizations,” says Dr. Manson.
The curriculum for this program provides the student with a more thorough understanding of integrated health care management including finance, cost-savings and return on investment, leadership and leading interdisciplinary teams. Clinicians who are not licensed or license-eligible, and students with a health care business/leadership background should consider a DBH management concentration.
Courses in a management concentration include:
- Behavioral health entrepreneurship.
- Cost offset and return on investment for behavioral intervention.
- Financial management in health care.
- Legal, ethical and professional health care issues.
- Quality improvement in integrated care.
This concentration can prepare students for careers such as:
- Clinical manager.
- Healthcare administrator.
- Healthcare consultant.
- Healthcare executive.
- Healthcare manager.
- Medical and health services manager.
- Project manager.
Earn a Doctorate of Behavioral Health with ASU Online
While true health care reform relies partially on government support and adoption of effective techniques across the industry, it also relies on providers who understand how best to use the policies to meet the medical and behavioral health needs of their patients, within the context of their community, culture, and their daily lives.
Graduates of the Doctorate of Behavioral Health with a clinical concentration will be prepared to implement these new policies, standing on the front lines of innovative, evidence-based health care practices that improve the lives of individual patients.
Graduates of the Doctorate of Behavioral Health with a management concentration, on the other hand, can be the ones to reform practices and policies at existing facilities — or start their own health care businesses — that utilize evidence-based strategies integrating behavioral health with primary care.
Faculty at ASU note that although both the clinical and management concentrations focus on primary care as the hub of integrated health care there are many other settings and positions in need of integrated health care clinical and management experience. These can include mental health and substance abuse settings, health plan and managed care organization integrated care programs, EAP, employee wellness, school, university, government and consultant positions.
The team continues on to explain that any setting that includes patients with co-morbid medical, behavioral, and health behavior issues presents an opportunity and need for integrated health care practice and management.
With a DBH, professionals can ensure nationwide compliance with best practices established by medical researchers, professionals and government advocates to improve health care outcomes for their patients. By spreading the use of integrative health care practices, patients can rest assured that their physical and behavioral health needs will be addressed in a simpler manner than in the past.