Magazine article Behavioral Healthcare Executive

Think and Act Strategically: Keep an Open Mind to Prevent Promising Opportunities from Slipping Away

Magazine article Behavioral Healthcare Executive

Think and Act Strategically: Keep an Open Mind to Prevent Promising Opportunities from Slipping Away

Article excerpt

My commentaries almost invariably address a key problem or a desirable development in the mental health or substance use care fields. This month, however, my focus is different. I think our fields lose many significant opportunities because we don't think and act strategically.

Allow me to explain. When an exceptional opportunity arises--a legislator offers unexpected support; a new report outlines advances for the field; a new solution arises to address a longstanding problem--we need to identify the opportunity, discuss how to make the best use of it, and plan an implementation strategy. We should not get lost in the forest because a particular tree impedes our view. Such "trees" might be compulsively editing a document about the opportunity, refusing to compromise about a particular word, arguing with those whose support we need to implement the opportunity, etc.

In the mental health and substance use care fields, examples abound of major areas in which we need new opportunities. Let me cite just a few national examples. We need opportunities to:

* provide mental health and substance use care coverage for the uninsured and underinsured;

* implement a national service benefit package for mental health and substance use care;

* adjust Medicare ambulatory care co-pays;

* coordinate Medicaid benefits with other federal and state program benefits;

* develop and implement modern training models for our providers;

* coordinate mental health and substance use services with primary care;

* increase consumer and family direction in our care system;

* implement a behavioral health component for electronic health records;

* implement national performance measures;

* etc., etc., etc.

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I have no doubt that you, too, can add to this long list. Yet will we actually recognize and accept an opportunity when it arises? Unfortunately, the answer is probably not.

What can we do about this dilemma? Here I offer just a few beginning thoughts. Please feel free to embellish this discussion.

We need to train ourselves to be more strategic in our thinking and action. Our self-help to achieve this new point of view can be guided by several principles outlined below. I have included an example--a proposal for a new federal mental health and substance use outpatient service benefit--to ground these ideas in practical experience.

Suspend Biases

Do recognize that we approach anything new with particular biases that may prevent us from fully appreciating its value. Identify these biases; write them down if necessary; and suspend them when considering the new opportunity. These biases frequently define the traditional fracture lines in our fields: mental health vs. substance use, public vs. private, family vs. consumer, adult vs. child, treatment vs. prevention, etc.

Don't simply conclude that the opportunity isn't any good, won't work, or will have bad effects.

Example: A prominent federal legislator proposes legislation supporting a new outpatient service benefit for mental health and substance use care. Don't assume that this is an effort by mental health to "take over" substance use care. Do ask yourself whether your biases are coloring your opinion about the benefit.

Focus on the Opportunity

Do think carefully about the new opportunity.

Don't engage in narrow thinking. Such thinking is frequently invalid. …

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