Behavioral health is an ongoing and critical issue across the
nation, but it is affecting communities in Rhode Island at an alarming rate.
According to a recent
report issued by the Blue Cross Blue Shield Association, Rhode Island
is well above the national average when it comes to depression diagnosis rates
-- coming in at 6.4 percent while the national average is 4.4 percent. With the
increasing need to provide behavioral healthcare to Rhode Islanders, especially
those facing mental health and substance use disorders, it’s more important
than ever to ensure providers and health insurers alike are working together to
guarantee care for Rhode Islanders. One area of concern is for those who are
uninsured -- a large population of approximately 45,000 Rhode Islanders for
whom it is much more difficult to find and access care.
This is our core mission at the Rhode Island Free Clinic (RIFC)
where we provide a comprehensive, volunteer-based medical home care to more
than 2,300 uninsured, low-income adults throughout Rhode Island. The RIFC has
been partnering with Blue Cross & Blue Shield of Rhode Island (BCBSRI) for
the last 15 years, starting out with assistance to recruit and retain
volunteers, and now helping us to deliver care to the uninsured.
Although the RIFC is well known for primary care, we have
evolved to focus on overall wellness for patients. We’ve implemented a variety
of programs like mental health counseling, social work, cooking and nutrition
classes, diabetes management and physical therapy. This is paying off -- since
2014, we’ve provided over 9,000 total wellness-related visits for 1,400
patients, and 50 percent of all patients have had a wellness appointment. It’s
clear our patients need this type of preventative healthcare.
Our focus on wellness also includes behavioral health. In 2017,
we conducted an assessment for all current and new primary care patients,
confirming the need for significantly more services centered around behavioral
health. Funding from partners like BCBSRI and growing collaborations with
academic and health partners is helping us bring more behavioral health
services to the uninsured, like integrated psychiatry, medication management,
psychotherapy, counseling services, social services and patient navigation –
all coupled with adequate staff training. We know it can be difficult to find
behavioral healthcare and hard to navigate the system to find the right help –
especially for those who are uninsured – but we are paving the way to be the
answer for those in need.
For example, A.F. is a 67-year-old Hispanic female who first
came to the RIFC in December 2017. During her first visits to the RIFC, she was
diagnosed with hypertension and high cholesterol, was prescribed free
medications, and began seeing a primary care provider regularly to manage her
condition. After one of her appointments, A.F. shared some emotional struggles
with the nurse she had been seeing for several months. A.F.’s son had died a
few months earlier, and she didn’t feel comfortable discussing her grief with
her husband. Our nurse immediately scheduled her for an appointment with a social
With this combination of primary care and behavioral health
services, A.F.’s blood pressure has steadily dropped and her cholesterol has
lowered dramatically. A.F. continues to meet weekly with a social worker not
only to help her deal with her grief and loss, but also to help and support her
through many life challenges on her journey to a healthier life.
We continue to expand our offerings at the RIFC; however, with
rate starting to creep up in our state, there is a
critical need to educate communities so these patients understand when
government healthcare changes are being made and what services are still
available. This is an uphill battle for the RIFC and Rhode Island as a whole,
and one we will only be able to overcome if we work together to support
uninsured adults around our state. We’re grateful to BCBSRI for their support,
and look forward to welcoming other community partners who share our commitment
to providing comprehensive health care to uninsured Rhode Islanders.
Marie Ghazal, DNP, RN, is the Chief
Executive Officer of the Rhode Island Free Clinic.