Behavioral Health Community Needs Assessment
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Behavioral Health Community Needs Assessment Presented By The North Texas Community Health Collaborative (CHC) Contact: Dr. Sushma Sharma [email protected] BH– CHNA Committee Brad Walsh (Chair) Parkland Health System Tyson Bain BSW Health System Sue Pickens Community Representative Ashleigh Kinney Texas Scottish Rite Hospital Rebecca Deisler The UT South Western Jeanne Nightingale Children’s Health des Anges Cruser RHP18 Jessica Galleshaw United Way Dallas Catherine Oliveros Texas Health Resources Dawn Zieger JPS Health System and RHP10 Tammy Mahan Life Path System Jennifer Sublett Medical City Sushma Sharma (Facilitator) DFWHC Foundation Jordania Lilly (Admin) DFWHC Foundation Furong Li (Intern) UNT Health Science Alexander Fernandez (Intern) UNT Health Science www.dfwhcfoundation.org 2 Behavioral Health Community Needs Assessment An Assessment of 16 North Texas Counties Collin, Dallas, Denton, Ellis, Erath, Grayson, Hood, Hunt, Johnson, Kaufman, Navarro, Parker, Rockwall, Somervell, Tarrant & Wise Total Population: 6,081,825 Area: 12,246.8 Sq. Mile www.dfwhcfoundation.org 3 Report Structure Introduction: Overview of CHC, Background & Purpose of BH-CHNA, Geographic Area and Community Characteristics & Assessment Overview Methods: Report Development Process & Data Sources Data Analysis: • Regional findings • 1-16 Counties (16 sections) • Community Characteristics • Clinical Data • Special populations (Homeless, Jails, Refugee, Sexual assaults and abuse, Suicidal Ideation) • Providers and Patient Survey results. Key Findings Recommendation's for Strategic Priorities www.dfwhcfoundation.org 4 Data & Information Sources • DFWHCF Data Warehouse (86 North Texas Hospitals) • Hospital Tracking Database (HS15DIR.dbf) • The Department of State Health Services (DSHS) • Merritt Hawkin’s Physician Workforce Survey Report • The United States Census Bureau • County Health Ranking and Roadmaps • Healthy North Texas (www.healthyntexas.org) • The Hogg Foundation Reports • MHMR Services, Metrocare services, NTBHA, Life Path Systems, RHP9, RHP18, RHP10 • Meadows Mental Health Policy Institute www.dfwhcfoundation.org 5 About DFWHCF Data Warehouse DFWHCF Data Warehouse Contains Comprehensive Hospital Visit Data from 86 Partner Hospitals www.dfwhcfoundation.org 6 Total Hospital Visits and No. of Patients in 2016 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 500,000 0 Total Visits Total Patients 2014 2015 2016 www.dfwhcfoundation.org 7 Charges Filed by Hospitals in 2016 Visits with Behavioral Health Diagnosis $25,000,000,000 $20,000,000,000 $15,000,000,000 $10,000,000,000 $5,000,000,000 $0 2014 2015 2016 www.dfwhcfoundation.org 8 BH Related Hospital Visits in 2016 County Square Miles per 1,000 Total Visits (Mental Health Adjusted Rate Population and Substance Misuse ) Erath 27.12 7,319 0.18 Navarro 19.33 3,658 0.07 Ellis 5.24 34,620 0.19 Grayson 7.27 5,201 0.04 Wise 13.33 15,438 0.23 Parker 6.42 16,908 0.12 Denton 1.07 91,717 0.11 Dallas 0.35 427,157 0.17 Tarrant 0.43 365,763 0.18 Collin 0.85 102,393 0.10 Hunt 8.85 20,772 0.22 Kaufman 6.06 19,891 0.15 Johnson 4.23 47,528 0.28 Hood 7.36 4,474 www.dfwhcfoundation.org0.08 9 Somervell 19.33 618 0.06 Rockwall 1.28 12,322 0.12 www.dfwhcfoundation.org 9 BH Related Hospital Visits in 2016 BH Hospital Visits by County (adjusted rate) www.dfwhcfoundation.org 10 Mental Health and Substance Misuse Visits Intersection Mental Health Substance Misuse Mental Health and Substance County Visits Visits Misuse Visits Intersection Total Visits Erath 3,663 2,988 668 7,319 Navarro 2,127 1,119 412 3,658 Ellis 20,167 11,259 3,194 34,620 Grayson 3,036 1,644 521 5,201 Wise 7,682 5,972 1,784 15,438 Parker 8,825 6,468 1,615 16,908 Denton 50,432 33,466 7,819 91,717 Dallas 216,974 157,028 53,155 427,157 Tarrant 188,767 130,891 46,105 365,763 Collin 62,833 30,012 9,548 102,393 Hunt 9,607 9,110 2,055 20,772 Kaufman 10,755 7,269 1,867 19,891 Johnson 24,275 18,568 4,685 47,528 Hood 2,793 1,244 www.dfwhcfoundation.org437 4,474 11 Somervell 355 181 82 618 Rockwall 8,530 2,740 1,052 12,322 www.dfwhcfoundation.org 11 Mental Health and Substance Misuse Visits Intersection Mental Health Sustance Abuse Both 134,999, 11% 620,324, 53% 420,456, 36% Behavior Health Visits in 16 Counties 2016 www.dfwhcfoundation.org 12 Emergency Department Visits By BH Patients (2016) Hospital System Cases Cases % (of total) 225,775 100% Medical City Healthcare 63,239 28% Texas Health Resources 37,784 17% Tarrant County Hospital District 35,892 16% Parkland Health & Hospital System 25,028 11% Baylor Scott & White Health 24,663 11% Methodist Health System 11,901 5% Baylor Scott & White (Tenet) 4,928 2% Childrens’ Medical Center of Dallas 4,784 2% Cook Children's’ Health Care System 4,743 2% Hunt Memorial Hospital District 2,461 1% Essent Healthcare 2,184 1% UTSW Medical Center University Hospitals 1,992 1% Texas Health Partners 1,822 1% Wise Regional Health System 1,530 1% Dallas Regional Medical Center 1,017 0% Universal Health Services 834 0% Province Healthcare 654 0% WNJ Regional Health System 188 0% www.dfwhcfoundation.org 13 Average Charges Patients with BH vs No BH Diagnosis (2016) $29,734.00 $30,034.00 $27,216.00 $23,473.00 $16,266.00 $13,728.00 $12,513.00 $11,947.00 $11,629.00 $8,670.00 $10,062.00 $8,268.00 $7,188.00 $10,279.00 $8,665.00 $7,902.00 $5,705.00 $4,249.00 0 - 17 18 - 26 27 - 35 36 - 45 46 - 55 56 - 65 66 - 75 76 - 85 > 85 Age in Years PATIENTS WITH MENTAL HEALTH DIAGNOSIS PATIENTS WITH NO MENTAL HEALTH DIAGNOSIS www.dfwhcfoundation.org 14 Age Distribution of BH Patients (2016) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% <=15 16-25 26-40 41-60 >=60 www.dfwhcfoundation.org 15 Pediatric vs Adult BH Visits in North Texas Count Percent County <=12 >12 <=12 >12 Collin 6,916 95,477 6.75 93.25 Dallas 20,422 406,735 4.78 95.22 Denton 3,301 88,416 3.60 96.40 Ellis 1,970 32,650 5.69 94.31 Erath 107 7,212 1.46 98.54 Grayson 389 4,812 7.48 92.52 Hood 159 4,315 3.55 96.45 Hunt 449 20,323 2.16 97.84 Johnson 1,164 46,364 2.45 97.55 Kaufman 815 19,076 4.10 95.90 Navarro 288 3,370 7.87 92.13 Parker 451 16,457 2.67 97.33 Rockwall 816 11,506 6.62 93.38 Somervell 18 600 2.91 97.09 Tarrant 9,477 356,286 2.59 97.41 Wise 282 15,156 1.83 98.17 www.dfwhcfoundation.org 16 Gender Distribution of BH Hospital Visits and Patients Visits Patients COUNTIES F% M% X% F% M% X% COLLIN 48.93 40.97 10.09 49.44 41.14 9.42 DALLAS 44.67 39.63 15.71 45.78 40.50 13.71 DENTON 51.80 40.08 8.12 50.38 41.75 7.87 ELLIS 52.10 40.72 7.18 50.51 42.55 6.93 ERATH 51.29 43.49 5.22 49.20 45.35 5.45 GRAYSON 49.26 43.68 7.04 49.58 43.39 7.02 HOOD 47.92 44.23 7.85 47.35 44.68 7.97 HUNT 52.17 40.28 7.54 50.68 42.37 6.95 JOHNSON 54.08 38.51 7.41 52.37 41.99 5.63 KAUFMAN 50.59 40.85 8.56 50.40 41.12 8.48 NAVARRO 47.68 42.56 9.76 47.47 44.09 8.45 PARKER 50.80 42.39 6.79 48.88 44.46 6.63 ROCKWALL 52.99 38.95 8.06 52.36 39.45 8.19 SOMERVELL 48.54 42.07 9.39 46.75 44.00 9.25 TARRANT 50.82 38.30 10.87 49.91 40.24 9.84 WISE 49.99 44.73 5.28 50.18 44.82 5.00 www.dfwhcfoundation.org 17 Race Distribution of BH Visits (%) Race (%) County White Black Other American Indian Asian Collin 72.5 11.6 12.7 0.2 3.1 Dallas 52.3 34.6 11.3 0.2 1.6 Denton 91.4 2.9 4.9 0.2 0.6 Ellis 78.5 12.9 8.4 0.1 0.1 Erath 71.2 10.1 16.4 0.1 2.1 Grayson 65.5 11.8 22.3 0.2 0.2 Hood 90.5 1.2 7.6 0.3 0.4 Hunt 76.0 10.2 13.1 0.1 0.6 Johnson 88.5 1.3 10.0 0.0 0.2 Kaufman 58.7 14.2 26.8 0.2 0.2 Navarro 83.4 3.9 12.2 0.2 0.3 Parker 87.8 0.6 11.3 0.0 0.3 Rockwall 52.4 3.5 43.6 0.0 0.6 Somervell 85.8 0.9 13.1 0.1 0.2 Tarrant 95.1 1.7 2.4 0.1 0.8 Wise 63.2 23.0 12.1 0.2 1.6 www.dfwhcfoundation.org 18 Ethnicity Distribution of BH Patients Visits (%) County Hispanic/Latino Non-Hispanic/Latino Unknown Ethnicity Collin 7.17 92.77 0.02 Dallas 17.75 82.20 0.02 Denton 6.44 93.50 0.03 Ellis 11.02 88.82 0.10 Erath 1.23 98.40 0.14 Grayson 4.67 95.21 0.04 Hood 4.05 95.13 0.78 Hunt 1.29 98.68 0.00 Johnson 3.49 96.29 0.17 Kaufman 3.85 96.07 0.03 Navarro 9.98 89.78 0.16 Parker 2.40 96.98 0.48 Rockwall 4.02 95.93 0.00 Somervell 2.91 96.28 0.49 Tarrant 10.5 89.12 0.33 Wise 5.03 94.80 0.08 www.dfwhcfoundation.org 19 Payer Status of BH Patients (%) www.dfwhcfoundation.org 20 Community Health Indicators Age-adjusted Death Rate due to suicide (deaths per 100,000 Depression: Frequent Mental Poor Mental Counties population) Medicare Population Distress Health: 14+ Days 2010-2014 2015 2015 2014 Collin 10.6 17.3 8.6 10.4 Dallas 10.4 18.2 10.7 12.2 Denton 9.8 19.2 9.0 11.1 Ellis 11.2 18.9 10.0 12.7 Erath 15.8 17.4 11.6 11.4 Grayson 17.8 19.2 13.9 13.8 Hood 14.7 17.6 9.9 11.6 Hunt 14.9 21.5 11.2 15.2 Johnson 16.4 21.8 12.1 15.8 Kaufman 13.3 18.6 10.3 11.2 Navarro 14.6 18.6 11.7 14.1 Parker 15.8 18.8 12.7 14.8 Rockwall 12.2 17.8 9.2 13.2 Somervell N/A 19.2 10.3 12.6 Tarrant 10.9 20.2 10.4 11.2 Wise 11.6 18.1 10.1 10.2 www.dfwhcfoundation.org 21 Provider Capacity – Psychiatry & Psychology Psychiatrists (2015): 2,052 in state; 1,933 in 2013 at a ratio of 13,794.4 Texans per psychiatrist; 12.7 % increase in 10 yr (adjusted growth) One child psychiatrist per 12,122 children in Texas.