A decade after the establishment of the certified community behavioral health clinic (CCBHC) model, more than 60 percent of the US population has access to such facilities and the mental health and substance use disorder treatment services they provide, according to a new study led by researchers at the NYU School of Global Public Health. Moreover, these clinics are expanding the availability of crisis mental health services, including mobile crisis response teams and stabilization.
CCBHCs fulfill federal criteria related to providing outpatient mental health and substance use care, including crisis services, regardless of patients’ ability to pay. The federal government established the criteria for the CCBHC model in 2014, and the first CCBHCs opened in October 2016. Clinics that become CCBHCs are typically community mental health centers that offered outpatient behavioral health care before becoming CCBHCs, but other types of facilities—like hospitals and federally qualified health centers—are also receiving CCBHC designation.
In a study published October 4 in JAMA Health Forum, the researchers found that CCBHCs have a wide-reaching network, with the proportion of US counties and people residing within a CCBHC service area substantially growing since the first clinics opened in 2016.
As of June 2024, 39.43 percent of counties are served by CCBHCs (22.85 percent of counties served by Medicaid CCBHCs and 25.37 percent of counties served by SAMHSA-funded Expansion CCBHCs, with some served by both). More than half of CCBHCs serve multiple counties. In addition, the majority of the US population—62.26 percent—have access to mental health care through local CCBHCs (26.63 percent by Medicaid CCBHCs and 53.93 percent by Expansion CCBHCs, with some served by both).
CCBHCs are required to provide the three main types of behavioral health crisis care: 24/7 call lines, mobile crisis response, and crisis stabilization. The need for crisis services has grown since the 2022 launch of 988, the new national number for the Suicide and Crisis Lifeline.
The research found that clinics receiving CCBHC Medicaid bundled payments had much higher odds of adding new crisis services when becoming CCBHCs than clinics not receiving these Medicaid payments.
The researchers also found that CCBHCs with higher staffing levels relative to the population they serve were more likely to directly provide crisis services, rather than contracting with third-party providers.
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