Local Health Departments Prevent Hospitalizations

Local health department operations have drastically changed over the last ten years as a result of the lingering financial effects of the Great Recession and the implementation of the Affordable Care Act, including the elimination of 55,000 jobs and clinical programs. These challenges have encouraged many health departments to rethink their goals and strategies, and leverage partnerships.

A recent study by researchers at the University of Maryland’s School of Public Health suggests that, by providing mental health preventive care and promotion activities, local health departments in Maryland reduced preventable hospitalizations for patients with mental illness by 7%. The reduction was seen across mood and anxiety disorders, schizophrenia and other psychotic disorders.

Expansion of services could not only play a critical role in decreasing racial disparities in hospitalizations, but also in the provision of mental health services to those with limited or no access to mental health.

Reductions in health disparities for African Americans were also observed. Compared to whites, African Americans were twice as likely to have a preventable hospitalization, slightly less likely to have a coexisting mental illness, and less likely to live in an area where local health departments provided mental health services. Evidence suggested that health department expansion of mental health promotion activities targeting the African American population could reduce disparities in preventable hospitalizations by 9%.

Further research demonstrating that strengthening local health departments can help hospitals reduce preventable hospitalizations may offer health care providers strong incentives to invest in such community partnerships as a means of sustaining high-quality service. With additional funding, health departments could expand and further integrate mental health services into their clinical practices. This expansion of services could not only play a critical role in decreasing racial disparities in hospitalizations, but also in the provision of mental health services to those with limited or no access to mental health.

Local health departments are well-suited to engage individuals with mental illness due to their low-cost services, high visibility, corresponding health promotion activities, and strong community partnerships.

The State of Maryland may want to consider this and other related evidence demonstrating the benefit of local health departments as they implement the Maryland All-Payer Model, which is a state-wide payment system for hospital services that strives to improve patients’ health and reduce costs. It is a unique opportunity to insert local health departments into the integrated health care delivery system to reduce hospital readmissions, improve care, and reduce costs. For example, local health departments could be incorporated into hospital discharge plans for follow-up mental health services, nutritional counseling, breastfeeding support, tobacco cessation services, and/or diabetes management.

Recent mass shootings have created a policy window of opportunity to direct additional funds towards mental health services, continue support of these services through Medicaid, and strengthen gun safety policies. Local health departments are well-suited to engage individuals with mental illness due to their low-cost services, high visibility, corresponding health promotion activities, and strong community partnerships. Possible funding opportunities through local health departments include providing mental health services as part of school-based care, increasing adult protective factor trainings and support groups, and simply providing equitably distributed programs to promote mental health and reduce mental illness.

Feature image: Nils Werner, Depression, used under CC BY CC BY-NC-SA 2.0