Person-centered planning and collaborative documentation were associated with greater engagement in services and higher rates of medication adherence.

Although most CMHCs had the capacity to screen for common medical conditions, they reported a variety of barriers to providing medical care for those problems either on site or via referral.

An "epidemic hidden in a pandemic". 1(np) That is what Andrea Raby, D.O. of Bayless Integrated Healthcare, calls the threat to our youth who are now at increased risk of substance use disorder and overdose in the wake of the COVID-19 pandemic. "This is always a vulnerable time during this period in their growth, in their development, in their growth of their identity, and often times what helps our adolescent population is structure and predictability and of course with COVID, this renders everything the opposite". 1(np) Transitioning to remote or hybrid classes, social lives put on pause, canceled athletics, and extracurricular activities leave some teens looking for ways to numb the pain. Dr. Raby is not alone in her concerns. Many experts believe the pandemic could lead to a nationwide spike in substance use disorders as people struggle with the anxieties and uncertainties borne of the pandemic. As much as we would like to believe that our young people are somehow protected from these temptations, in truth, no group is more vulnerable. Left unchecked, addiction and substance use among young people can accelerate poor health outcomes and lead to even worse behaviors as adults. Youth who are desperately in need of care may not get the services they need if no one identifies the problem early. We know little about the emerging threats of COVID-19 on our youth. As I write this in late September 2020, we are experiencing the phenomenon of "COVID fatigue" and with it, some people are demonstrating a more cavalier approach to wearing masks and social distancing. A new school year is being defined by remote learning and hybrid classes, businesses are feeling the financial pains of prolonged restrictions, and we are facing the advent of the annual "flu season". Much of the insight we do have about this issue is based on observations of previous disasters. A Dutch study tells us that, in the long run, the negative behavioral and emotional problems for adolescents decrease with time, but the effects regarding alcohol use remain. 2 In the aftermath of Hurricane Katrina, "survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol consumption-related problems at a substantially higher rate". 3(p.1) A Canadian study on adolescent substance use pre-and post-COVID-19 found that, "For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%)". 4(p.1) To be sure, this is just one study that focused on a relatively small

No abstract

The COVID-19 pandemic has made it clear how vital behavioral health professionals are to our individual health and to the health of our communities. More than ever, behavioral health professionals provide clients with life-saving treatment and services. It is truly hard to imagine where we would be as a nation without care from behavioral health professionals. The need will only intensify in the weeks and months ahead as we face a long period of recovery of our health, spirit, and economy, addressing the inevitable toll of long-term trauma on the nation's mental health.For many of us, the future is uncertain. Clinics providing needed services to some of our nation's most vulnerable, those living with mental illness and addictions and their families, are struggling to keep their doors open. The victims of these closures will not only be their patients and clients, they will be the staff who have bravely put their own fears aside to provide comfort and treatment.While the future is unclear and the full extent of the health crisis is still unfolding, I see promising signs of hope. The behavioral health field has always embodied strength and resilience, and that is certainly true right now.Even in these dark times, I have seen the power of unity and what can happen when we speak with one voice to let our nation's leaders know our wide-ranging contributions and our great needs. The National Council has joined our voices with organizations, policymakers, and individuals within our own community. Our list of victories is inspiring, and it is all because we recognize that we are better together.Our strength was evident as we spoke up to Congress and they listened. We secured policy changes supporting our community, gaining latitude in the use of telehealth and expansion of audio-only telehealth and Medicare coverage for a wider range of providers of telehealth services. Such efforts included Medicaid nonprofits in the Paycheck Protection Program and temporary relief of the Ryan Haight Act which allowed greater flexibility to prescribe controlled substances like antipsychotics and medication-assisted treatment (MAT), among others. In addition, the National Council spearheaded the largest mental health and addiction advocacy request in history, leading the effort for 40 other advocacy organizations to sign a request totaling $38.5 billion for behavioral health providers.However, we still have far to go. As the nation continues to grapple with and recover from COVID-19 and its aftershocks, we need continued investment in behavioral health. There are