Report Type: Data Profile Medicaid
NM Behavioral Health Resource Mapping & Needs Assessment
YEAR
2020
AUTHOR / ORGANIZATION
UNM School of Medicine, Dept of Psychiatry & Behavioral Sciences, Division of Community Behavioral Health
GEOGRAPHIC SCOPE
Bernalillo County, Statewide (New Mexico)
What is this?
This is a statewide behavioral health resource mapping and needs assessment produced by the University of New Mexico's Department of Psychiatry and Behavioral Sciences, Division of Community Behavioral Health in March 2020. The report was commissioned to provide a comprehensive picture of federal funding flows and behavioral health needs across New Mexico. The methodology combines multiple data sources: SAMHSA and HRSA federal grant data (2013-2018), the National Survey on Drug Use and Health (NSDUH), New Mexico BRFSS, NMDOH vital records, hospital discharge data, and a new analysis of Medicaid claims from April 2018 to March 2019. The Medicaid analysis covers 190,835 clients with serious mental illness, severe emotional disturbance, or substance use disorders, examining demographics, diagnoses, treatment patterns, chronic conditions, and costs by county.
Summary
This assessment establishes critical baseline data for behavioral health systems planning in New Mexico. Key findings directly relevant to systems change include: only 12% of the state’s mental health care needs are being met; 24% of Medicaid clients with behavioral health diagnoses received no behavioral health treatment; and treatment access varies dramatically by geography, with rural counties showing treatment rates as low as 64% compared to metropolitan areas at 78%. The report identifies opioid use disorder as the most prevalent SUD (52.1%), followed by alcohol use disorder (36.3%), suggesting prioritization targets for intervention. Co-occurring disorders are common—13.6% of clients have both mental health and substance use diagnoses, and 55.6% have at least one chronic physical condition, underscoring the need for integrated care models. Bernalillo County, with 58,077 Medicaid behavioral health clients (the largest county population), shows relatively better treatment rates but still has 22% receiving no treatment. The workforce data showing psychiatrist numbers decreased by 41 since 2013 while demand increased points to urgent workforce development needs. For systems planners, this data supports targeting integrated care expansion, rural service development, and SUD treatment infrastructure—particularly for opioids.
BH Systems Change Recommendations
How This Report Informs Systems Change: This report does not contain explicit behavioral health systems change recommendations but provides essential baseline data to inform systems planning: 1. **Address Treatment Gaps**: The 24% of clients receiving no behavioral health treatment—and 30.6% of SUD-only clients—represents a clear target for intervention. Systems planners should investigate barriers to treatment access, particularly for SUD services. 2. **Prioritize Opioid and Alcohol Use Disorder Services**: With 52.1% OUD and 36.3% AUD prevalence among SUD clients, expanding medication-assisted treatment, recovery support, and harm reduction services should be prioritized. 3. **Expand Integrated Care Models**: The high prevalence of co-occurring chronic physical conditions (55.6%) and the fact that 36.6% of costs are acute care suggests opportunity for cost savings through integrated behavioral-physical health care. 4. **Target Rural Service Expansion**: Rural counties show treatment gaps up to 36.5% (McKinley County) versus 22% in Bernalillo County. Mobile services, telehealth, and workforce incentives should target these areas. 5. **Address Workforce Crisis**: With only 12% of mental health needs met and psychiatrist numbers declining, workforce development is essential—including expanding scope for non-physician providers and peer specialists. 6. **Expand Youth Trauma Services**: High rates of trauma/stressor disorders among youth (36% of cases) indicate need for trauma-informed care expansion in schools and pediatric settings. 7. **Leverage Funding Strategically**: With 57% of SAMHSA funds going to SUD and only 43% to mental health while 79% of clients have mental health disorders only, systems planners should advocate for funding alignment with population needs.
How to Use for Systems Planning
**What this report IS useful for:** - Establishing baseline prevalence data for behavioral health conditions in New Mexico and by county - Understanding Medicaid population demographics, diagnoses, and treatment patterns - Identifying geographic disparities in treatment access and outcomes - Quantifying workforce shortages and unmet need - Understanding federal funding levels and allocation patterns - Analyzing cost patterns for behavioral health clients - Benchmarking Bernalillo County against state averages and other counties - Supporting grant applications with population-level data **What this report DOES NOT provide:** - Specific recommendations for systems change or policy interventions - Provider-level or organization-level capacity data - Wait time or quality metrics for behavioral health services - Non-Medicaid population treatment data (commercially insured, uninsured, VA) - Current workforce vacancies or hiring needs - Information on crisis services, mobile crisis, or 988/crisis line data - Analysis of social determinants of health or community-level risk factors - Projections or trend analysis beyond historical data
Key Facts & Data Points
- 190,835 Medicaid clients with behavioral health diagnoses received care in NM (April 2018-March 2019) - 78.8% had mental health disorder only; 7.6% had SUD only; 13.6% had co-occurring disorders - 52.1% of SUD clients had opioid use disorder; 36.3% had alcohol use disorder - 24% of clients with behavioral health diagnoses received no behavioral health treatment - Only 12% of NM's mental health care need has been met (vs. 27% nationally) - Psychiatrist numbers decreased by 41 since 2013 - $48.2 million in SAMHSA funding allocated to NM in 2018 (57% for SUD, 43% for mental health) - $107 million in HRSA funding allocated to NM in 2018 - Health insurance coverage increased from 78% (2013) to 89% (2017) - 55.6% of behavioral health clients also had at least one chronic physical condition - $2.15 billion spent on health care for Medicaid clients with behavioral health diagnoses - 11.6% of costs ($228 million) were for outpatient behavioral health care - NM alcohol-related chronic disease mortality rate is 1.5-2x the national rate - 6,789 alcohol-related deaths, 2,470 drug overdose deaths, 2,335 suicides (2013-2017) - Bernalillo County had 58,077 behavioral health Medicaid clients (largest county)
Priority Services & Findings
**SUD Organizations** - Opioid use disorder is most prevalent SUD at 52.1% of SUD clients - Only 7.1% with alcohol dependence/abuse and 9.1% with drug dependence/abuse received treatment - Clients with SUD only had highest rate of no treatment (30.6%) - 16% of SUD clients had liver disease (vs. 5.4% of mental health only clients) - Amphetamine and other stimulant use disorders each affected 17.9% of SUD clients - Cannabis use disorder common among youth (50.8% of youth SUD diagnoses) **Mental Health / Crisis Care** - 5.6% of NM adults experience alcohol use disorder annually (~117,500) - 4.5% experience serious mental illness annually (~94,500) - 19.1% experience any mental illness annually (~404,400) - 7% of adults thought about suicide in the past year (~168,000 people) - Depression (48.3%) and anxiety (47.9%) most common mental health diagnoses - Trauma/stressor-related disorders affected 36.7% of mental health clients; 36% were under 18 - 2,335 suicide deaths 2013-2017; rate 1.5-1.9x national average since 1981 **Integrated Primary Care** - 55.6% of behavioral health clients had at least one chronic physical condition - Clients with co-occurring MH/SUD most likely to have chronic physical conditions (68%) - Chronic pulmonary disease (17.3%), obesity (14.7%), liver disease (8.4%), diabetes (8%) most common - 36.6% of costs for BH clients were acute care; only 11.6% for outpatient BH care - Average monthly cost $1,012 per client; $102 for behavioral health care **School-Based / Youth Services** - 27.7% of Medicaid BH clients were under 18 (52,869 youth) - 36% of trauma/stressor-related disorder clients were under age 18 - Neurodevelopmental disorders affected 30.5% of youth with mental health diagnoses - ADHD medications most common prescriptions for youth - 50.8% of youth SUD diagnoses were cannabis use disorder
Immediate Actions for Systems Planners
-Use Bernalillo County-specific data (58,077 clients, 22% untreated, 14.2% co-occurring disorders) to establish baseline metrics for any behavioral health systems change initiative and track progress over time. -Share the finding that 30.6% of SUD-only clients receive no treatment with SUD providers and policymakers to advocate for expanded treatment capacity and reduced barriers to care. -Present the co-morbidity data (55.6% with chronic physical conditions) to primary care networks and managed care organizations to build the case for integrated care models. -Use the workforce shortage data (12% of need met, psychiatrist decline) in advocacy efforts for workforce development funding, training program expansion, and scope of practice policies. -Map the geographic treatment disparities to inform decisions about where to locate new services, deploy mobile units, or expand telehealth infrastructure. -Share youth trauma prevalence data (36% of trauma cases under 18) with school districts and children's services to support school-based mental health expansion. -Reference the opioid use disorder prevalence (52.1% of SUD) when planning MAT expansion, naloxone distribution, and harm reduction services.
Key Contacts
**/ - Dr. Tyler Kincaid, UNM Dept of Psychiatry & Behavioral Sciences, Division of Community Behavioral Health -+ twkincaid@salud.unm.edu **/ - NM Human Services Dept, Medical Assistance Division **/ - NM Health Care Workforce Committee = - NM Dept of Health