How Sentara is expanding care for mental health and substance abuse issues
By Charles “Ken” Dunham, M.D., Executive Director of Medical Operations for Behavioral Health at Sentara Health
This post is part of our Improving Health Leadership Blog, which explores Sentara’s leadership on issues affecting the health and well-being of our consumers and how we’re pioneering new ways to make health care simple, seamless, personal, and more affordable
This post is part of our Improving Health Leadership Blog, which explores Sentara’s leadership on issues affecting the health and well-being of our consumers and how we’re pioneering new ways to make health care simple, seamless, personal, and more affordable
At Sentara, we recognize that mental and substance abuse challenges are interwoven with physical health. When it comes to health care, supporting the mind is as important as treating the body.
There is a large and growing need for behavioral health services, a term that encompasses mental health and substance abuse treatments. Around one in five adults experience mental illness, while 5% have serious thoughts of suicide at some point in their life. In 2022, nearly 108,000 people died from drug overdoses, a five-fold increase from 2002.
Barriers to care persist. In a 2022 survey, a third of people reported they could not access the mental health services they needed. When asked about the main obstacle, 80% cited cost, while more than 60% cited shame and stigma. Another survey from the same year highlighted the shortage of mental health providers, with 60% of psychologists reporting no openings for new patients. And when you do get an appointment, the national wait time for behavioral health clinics is about 48 days.
The Covid-19 pandemic exacerbated many of these gaps. But the pandemic also led to conversations and spotlighted the need for change.
At Sentara, we believe it’s our responsibility to help overcome barriers to behavioral healthcare and support holistic health. To better meet the needs of the communities we serve, we're expanding our services strategically and sustainably.
Our behavioral health expansion can be divided into three key areas:
Integration of mental and physical care also makes financial sense. The reduced overhead of adding a therapist to an already existing practice means a more sustainable operating model. And, for insurance plans, the health economics are positive because patients in clinics with integrated behavioral health are less likely to go to the emergency department or hospital, which not only helps the patient but saves money for the patient’s health plan.
The growth of our embedded therapist program has already produced a dramatic increase in services. After hiring three embedded therapists in 2024, Sentara’s team completed 5,513 patient visits in 2024, a 54% increase from 2023.
In 2022, we opened a behavioral healthcare clinic in Virginia Beach, Virginia, which was our first clinic focused on accepting patients from hospitals and emergency departments who needed to be seen within seven days after discharge. In the first two years of operation, our new model reduced hospital readmissions by 20% and improved our Sentara Health Plans expenses for patients by 7%. In spring of last year, the clinic expanded its schedule, offering virtual appointments on weekends and weeknights.
The results have been positive. We are averaging around 500 additional visits per month in the virtual and after-hours slots, and we have seen more new patients in the expanded slots compared to other slots, which shows that we have improved access. We have also received positive feedback from community members, especially those with transportation or childcare limitations.
We continued our brick-and-mortar expansion in November 2024, establishing a new clinic for behavioral healthcare in Hampton, Virginia, across the street from the Sentara CarePlex Hospital.
Overall, the goals of these clinics include helping patients before they have a crisis, as well as helping them after a crisis as they transition back to the community from an emergency department or psychiatric hospital.
As part of this initiative, there will be an on-site navigator in 10 of our hospitals and a virtual presence at two others. In addition, eight Sentara behavioral health navigators will be stationed at non-Sentara facilities across Virginia to serve the needs of Sentara health plan members.
Our behavioral health navigators partner with medical staff to identify mental health needs and connect patients to providers. They also coordinate follow-up appointments and address barriers to treatment. They provide their services in all medical units, including in emergency departments.
The goal is to help patients and health plan members get connected to the right resources as quickly as possible.
At Sentara, our goal is to improve health every day. As a non-profit safety net institution, we have a responsibility to expand access to behavioral health services. That way, we can build a system to support overall wellness at every stage of life.
There is a large and growing need for behavioral health services, a term that encompasses mental health and substance abuse treatments. Around one in five adults experience mental illness, while 5% have serious thoughts of suicide at some point in their life. In 2022, nearly 108,000 people died from drug overdoses, a five-fold increase from 2002.
Barriers to care persist. In a 2022 survey, a third of people reported they could not access the mental health services they needed. When asked about the main obstacle, 80% cited cost, while more than 60% cited shame and stigma. Another survey from the same year highlighted the shortage of mental health providers, with 60% of psychologists reporting no openings for new patients. And when you do get an appointment, the national wait time for behavioral health clinics is about 48 days.
The Covid-19 pandemic exacerbated many of these gaps. But the pandemic also led to conversations and spotlighted the need for change.
At Sentara, we believe it’s our responsibility to help overcome barriers to behavioral healthcare and support holistic health. To better meet the needs of the communities we serve, we're expanding our services strategically and sustainably.
Our behavioral health expansion can be divided into three key areas:
1. Integrating behavioral healthcare into primary care
Behavioral health shouldn’t exist in a silo. To bring mental and physical care under one roof, we are embedding therapists in primary care practices. This helps ensure timely access, makes behavioral healthcare routine, and reduces stigma.Integration of mental and physical care also makes financial sense. The reduced overhead of adding a therapist to an already existing practice means a more sustainable operating model. And, for insurance plans, the health economics are positive because patients in clinics with integrated behavioral health are less likely to go to the emergency department or hospital, which not only helps the patient but saves money for the patient’s health plan.
The growth of our embedded therapist program has already produced a dramatic increase in services. After hiring three embedded therapists in 2024, Sentara’s team completed 5,513 patient visits in 2024, a 54% increase from 2023.
2. Expanding our clinics and hours
To meet patients where they are, we are expanding our brick-and-mortar clinics and offering increased virtual options.In 2022, we opened a behavioral healthcare clinic in Virginia Beach, Virginia, which was our first clinic focused on accepting patients from hospitals and emergency departments who needed to be seen within seven days after discharge. In the first two years of operation, our new model reduced hospital readmissions by 20% and improved our Sentara Health Plans expenses for patients by 7%. In spring of last year, the clinic expanded its schedule, offering virtual appointments on weekends and weeknights.
The results have been positive. We are averaging around 500 additional visits per month in the virtual and after-hours slots, and we have seen more new patients in the expanded slots compared to other slots, which shows that we have improved access. We have also received positive feedback from community members, especially those with transportation or childcare limitations.
We continued our brick-and-mortar expansion in November 2024, establishing a new clinic for behavioral healthcare in Hampton, Virginia, across the street from the Sentara CarePlex Hospital.
Overall, the goals of these clinics include helping patients before they have a crisis, as well as helping them after a crisis as they transition back to the community from an emergency department or psychiatric hospital.
3. Placing behavioral health navigators at hospitals and other healthcare facilities
Navigating health care is complex. Navigating behavioral health can be even harder, especially if you are having a crisis and end up in an emergency department or hospital. After successfully piloting a behavioral health navigator role, Sentara is expanding this position to all 12 Sentara hospitals to help people get the support they need.As part of this initiative, there will be an on-site navigator in 10 of our hospitals and a virtual presence at two others. In addition, eight Sentara behavioral health navigators will be stationed at non-Sentara facilities across Virginia to serve the needs of Sentara health plan members.
Our behavioral health navigators partner with medical staff to identify mental health needs and connect patients to providers. They also coordinate follow-up appointments and address barriers to treatment. They provide their services in all medical units, including in emergency departments.
The goal is to help patients and health plan members get connected to the right resources as quickly as possible.
Our vision for behavioral healthcare
Behavioral health is a key component of overall health. When patients have an improvement in their depression, substance abuse, or other behavioral health issue, the rest of their health follows.At Sentara, our goal is to improve health every day. As a non-profit safety net institution, we have a responsibility to expand access to behavioral health services. That way, we can build a system to support overall wellness at every stage of life.