Ari Kalechstein, Ph.D.

Our 25th anniversary was a year to remember. Having started it at the height of the pandemic, we adapted to a constantly evolving and booming mental healthcare market, and it worked.

We invested in an award-winning telehealth offering, paid careful attention to new Centers for Medicare & Medicaid Services payment requirements, brought in new staff, and made the most of a difficult year.

And yet, while we’ve transformed and accomplished much, we’ve also reached a moment where we are able — and challenged — to focus on ourselves to continue to support others.

Remember the old proverb where the shoemakers are always the worst shod? That’s one that might apply to many of us in healthcare. We need to think of ways to provide for the quality of life for clinicians, so that we can continue to ensure a good future for us all.

Here are four things I’m seeing as we enter a new quarter-decade of service in support of older adults’ mental health:

  • The pandemic is just one of many challenging issues for America’s mental health. When thinking about the state of mental healthcare, we can reflect on how these past two years were just a series in a long line of challenging moments in our country’s state of mental health. The pandemic was instructive in terms of understanding the severity of mental health difficulties and how people are afflicted, but there are other landmark events that have changed the way we look at mental illness in recent years — from the increase in homelessness to the aftereffects of 9/11. We can’t treat the mental health effects of the pandemic as a temporary blip on the radar but as a signal of a greater undercurrent of mental healthcare issues that require attention.
  • There’s an increasing need for mental health services for older Americans. America is “going gray,” and by that, we mean there is an increasing need for more services for older adults. It’s going to be important for providers of healthcare to have the necessary resources to provide the care that people need, and that means more conversations with insurers. Together, we need to ensure Medicare and Medi-cal will provide adequate reimbursement for clinicians to provide the services that people are going to need.
  • More work, fewer clinicians, less reimbursement. There are two key issues we are seeing as clinicians with regard to mental healthcare. First, it’s getting increasingly more challenging to find qualified clinicians to support an ever-increasing demand for mental health services. Second, we are also challenged by the many changes in insurance reimbursement. If you track how reimbursement for a particular activity has been over the past 10 years and adjust that to inflation, reimbursement has decreased. To sustain a healthy mental health business, together with our industry partners, we need to advocate for an increase in reimbursement aligned with current economic conditions.
  • Work-life balance is of critical importance for clinicians. Things are rough and will continue to get more challenging. Our aim as a company is to create a business model that allows clinicians to feel good about the work that they do, know they are valued, and enjoy a good work-life balance. Clinicians today are concerned about remuneration but also about the autonomy to manage their schedules and a desire for support and guidance in their patient work. Our clinicians have seen and heard a lot in the last two years, and the compassion fatigue is salient. Our goal as a company is to help our staff manage that stress, allow them the flexibility to live their lives, and facilitate processes so they feel good about the great work they are doing at the end of each day.

While each of these points reflects in on the need for partnering for change, there are bright signs for us on the horizon.  For instance, in the United States, we are becoming more comfortable in terms of openly discussing concerns about mental health. People are more open to telemedicine for therapy, to using digital tools to boost mental health, and CMS is acknowledging that remote care is integral to providing interventions for those in need.

Workplaces are also beginning to foster and support a culture of mental health with resources and access to mental health services. And importantly, states are increasingly directing funding to mental healthcare support — such as California’s $518.5 million in grants to help provide services and housing options to those with severe mental illness or substance abuse problems.

For those reasons and many more, I am hopeful for our industry and for the continued growth and better mental healthcare in the U.S. And like the adage says, “If you want to go fast, go alone. If you want to go far, go together.” For us, together is the only option.

Ari Kalechstein, Ph.D., is the president and CEO of Executive Mental Health and offers 25 years of experience as a licensed psychologist in the States of California and Nevada. With the support of his colleagues, Dr. Kalechstein spearheaded the development of a comprehensive suite of services at EMH, which include neuropsychological evaluations, clinical psychological interventions, and forensic mental health evaluations. 

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.