Arizona consistently ranks among the worst in the nation for mental health access and outcomes, with the tenth-highest prevalence of mental health illness among adults (23.89%), one of the lowest mental health workforce-to-patient ratios, and the second-highest prevalence of untreated mental illness (63.5%) (Mental Health America, 2023). Lack of access to care and social determinants of health disproportionately affect marginalized communities, leading to higher rates of untreated mental illness and substance use disorders (SUD). Women in particular experience unique mental health challenges during the pre- and post-natal periods; postpartum depression and anxiety affects 1 in 7 women in Arizona (AZ Department of Health Services, 2021). Additionally, the pediatric population is currently experiencing a mental health crisis, with increasing rates of depression, anxiety, and suicide. The need for support services in an integrated setting is more critical now than ever before.
For almost 150 years, Valleywise Health (VH) has been Arizona's only public teaching hospital and safety-net health care system serving low-income and diverse populations. As a leader in integrated and specialty behavioral health care, VH’s Integrated Behavioral Health (IBH) team offers physical and mental health services under one roof to address whole person needs of our patients and their families. Additionally, our comprehensive services include inpatient psychiatric care, Assertive Community Treatment (ACT), Forensic Assertive Community Treatment (FACT), and two First Episode Centers (FEC). We are also addressing the national shortage of behavioral health providers through the Creighton Arizona University Health Education Alliance. We currently have twenty-four general psychiatry resident positions and eight child and adolescent psychiatry fellows.
In 2022, VH provided mental health services to 4,915 patients over 26,583 clinic and virtual visits (UDS, 2022). Across the health system, 1,272 patients received a diagnosis of substance-related disorder, excluding alcohol and tobacco, and 6,130 received a diagnosis for depression or other mood disorders. VH has 25.31FTE mental health employees, including psychiatrists, licensed clinical social workers, and other mental health personnel.
While VH delivers high-quality behavioral health care services throughout our dedicated hospitals and FQHC network, there is increasing demand beyond our staff’s current capacity. To address these needs, VH seeks to expand our IBH services for women and pediatric populations at the Women’s Clinic in the Comprehensive Health Center (CHC) in Phoenix, Arizona. Our goal is to increase the number of patients who receive care for mental health and substance use disorders and expand the workforce necessary to provide high-quality care. Strategies to achieve these goals will include: 1) increasing the number of IBH clinicians and nurses to serve the behavioral health needs of women and children; 2) expanding the availability of medication-assisted treatment (MAT) services for these populations; 3) increasing screening for SUDs including Opioid Use Disorders (OUD); 4) provide training and education to primary care providers including IBH clinicians, psychiatrists, and peer and family support specialists; 5) adding Certified Family and Peer Support Specialists to help women and children navigate care; and(6) supporting clinicians at the CHC Women’s Clinic in obtaining their perinatal certification. These actions will help VH, our community, and the state address gaps in the treatment and support of women and pediatric patients with mental health and SUDs. Success at the end of the grant term will be measured by the increased number of patients who receive mental health and SUD services, including MAT services and supports. Expanding behavioral health at VH is essential to addressing urgent needs and improving the health and well-being of Arizona’s most vulnerable residents.