An examination of policy-level factors and affect behavioral health and behavioral health care in Kansas

Abstract

The lack of access to behavioral health care, trends in behavioral health issues, and the impact of social determinants of health underlie the need for behavioral health reform in Kansas. A mixed-methods study examined the attitudes and recommendations of elected officials, state employees, payers, and health advocates. Although stakeholders supported most policies that facilitate primary care and behavioral health integration, elected officials and payers were less likely to support financial incentives for primary care practitioners who treat gender dysphoria than health advocates and state employees did. Payers perceived legislation to improve insurance coverage for behavioral health issues as less beneficial than state employees and health advocates did. Elected officials perceived legislation to address various social determinants of health as less beneficial than health advocates did. Seven themes were identified from text-based recommendations to improve behavioral health services and outcomes: (1) access; (2) capacity and sustainability; (3) social determinants of health; (4) public safety and criminal justice responses; (5) parity; (6) integration; and (7) opposition to government involvement in the behavioral health system. Five themes were identified from semi-structured interviews: (1) behavioral health workforce development; (2) criminal justice reform; (3) payment and health insurance reform; (4) policymaking processes; and (5) access to care. Preliminary findings may reflect both the barriers and facilitators to behavioral health reform in Kansas. However, several limitations undermined the generalizability of these findings. Future studies should consider more representative sample sizes, additional variables in behavioral health and social determinants of health policies, and more comprehensive, validated measures.