Some 54,000 of New Jersey’s emergency room visits in 2016 were related to patients’ behavioral health issues, like addiction. The Attorney General’s Office has reported the opioid epidemic is on pace to claim more than 3,000 lives this year. Expanding access to treatment is behind the merger of Hackensack Meridian Health and addiction services provider Carrier Clinic. Its president and CEO Don Parker joins Correspondent Leah Mishkin.
Mishkin: Let’s start with this merger with Hackensack Meridian Health. What will this mean to have a powerhouse in behavioral health merge with such a big hospital network?
Parker: It means access, access and more access. So, Carrier Clinic is going to be located with different services in each of the 16 hospitals that are in the Meridian Hackensack system. We’ll have some central locations for inpatient care. And then you will see leaps and bounds of technology coming in to behavioral health, which has not been known for its high-tech ideas and treatment.
Mishkin: So you’re bring mental health and substance abuse services to the Hackensack hospitals. But was that not there already, or it’s being enhanced by having you join those facilities?
Parker: So we’re going to be working in partnership with all of our colleagues at Hackensack Meridian, and they have enormous talent. And it’s been organized hospital by hospital, for the most part. This will allow us to work together, share all our best practices, talent, be able to identify special needs and route them to the right hospital. We will be organizing centers of excellence for behavioral health in the same way you have for cancer. It doesn’t happen today; you get put in a generic unit, for the most part. So, it’s a whole different world for behavioral health.
Mishkin: When you think about behavioral health and also substance abuse, it’s expensive to get treatment, and it also seems like access is limited. By having these two powerhouses merge, will that help accessibility or the costs for patients?
Parker: Well, I think it’s going to — access will increase, as I mentioned. But cost of that access will go down. We are going to introduce some new strategies into how we do our work, like a behavioral health urgent care center. Something that’s lower cost than an emergency room; higher capability than your doctor’s office and is open evenings and weekends, when you need it the most, so we’ll have a variety of supplemental services. And then we have a telepsychiatry system that will be deployed across the system. You’ll get access to experts any time of the day or night, or off-times on the weekends. So I think it’s going to give us the opportunity to spread what we do, and then join it with a system that’s already a Cracker Jack top-notch system.
Mishkin: And going off of that, I know it’s a long-term goal to bring these mental health services to urgent cares, but how exactly is that going to work? How do you envision that working?
Parker: Well, it’s not such a long-term goal. We’re already starting on design — next week, I have some meetings with people at Hackensack Meridian to take a look at the model itself, along with some expertise in New York, called City MD. They operate a bunch of urgent care centers in that market. We’re going to talk about how we can get that off the ground and get it off the ground quickly. We’re in the middle of an epidemic. There’s no time for us not to get that ready for the public.
Mishkin: But how does that work? In a sense, a patient walks in. It’s one thing if you’re prescribing them antibiotics for something, but, mental health — it probably takes multiple visits.
Parker: So, what we have to do is increase our capability. So one of the items I just mentioned, our telepsychiatry, we’re embedding facial recognition software. Micro-element facial expressions, that are half a second long, that can’t be seen by the naked eye. We have them correlated with various diagnostic states, so it will enhance the capability if somebody is coming in via video, which you may have thought to be an inferior product in the past. We’ll have nurse practitioners with the expertise — child, adolescent, adult, dual and geripsychiatry — expertise like that, out of our telepsychiatry network. So you’ll have on-the-spot capability, which you can’t get. Try to get any one of those specialties in a timely basis, and it just doesn’t happen. We’ll be able to do those kinds of things, and we’ll do it at lower costs. It’s not an inpatient stay. It’s not an emergency room visit. And if you look at how urgent care is priced, it’s a much lower price. And then we’ve got a variety of other techniques, like we can take down elevated behavior, levels of elevated behavior, using acoustical stimulation. So, we have an Eastern/Western smash-up. We stimulate chakras with acoustics, and then we stimulate your vagus nerve. It calms you down. So those are the things that people have been concerned about doing in an urgent care center that we think that we can do and make it beneficial and safe for patients.
Mishkin: And I had read that this telemedicine is helping with a looming shortage. Do you see technology — how do you see that playing a part in mental health? Do you think it will — is that the way it’s going?
Parker: Well, I’m extremely interested in technology as a strategy in behavioral health because we use so little of it. If you look at what happens in a drug and alcohol episode, we’ve been able to use technology to identify, along with a lot of our colleagues in our profession, the shrinkage of the hypothalamus gland during a substance abuse episode — can’t sleep, can’t concentrate, can’t experience pleasure through the emission of endorphins. We can stimulate that electronically using very, very low stimulation. It’s called a TENS unit for the brain. It actually rehabilitates your hypothalamus, so when you walk out of Carrier Clinic, you’re ready to take on the things that are in front of you and the challenges that you have, as opposed to waiting for your hypothalamus to come back into action. I think that wait is what causes people problems. So, that’s just a small example.