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An Employers Guide to Behavioral Health Services

Publication Type: External Publication, Other Report

A roadmap and recommendations for evaluating, designing and implementing behavioral health services.

What is Behavioral Healthcare?
Behavioral healthcare is an umbrella term and refers to a continuum of services for individuals at risk of, or suffering from, mental, behavioral, or addictive disorders.

Behavioral health, as a discipline, refers to mental health, psychiatric, marriage and family counseling, and addictions treatment, and includes services provided by social workers, counselors, psychiatrist, psychologists, neurologists, and physicians. In this
publication, the term “employer-sponsored behavioral healthcare services” refers to all employer-sponsored services that address mental health or substance abuse problems including services offered through the health plan, disability management programs,
EAP, and health promotion or wellness programs.

What is a Mental Illness?
Mental illness/behavioral health disorder (also known as mental disorder): is a health condition that is characterized by alterations in thinking, mood, or behavior (or some combination thereof), that is mediated by the brain and associated with distress
and/or impaired functioning. Mental disorders cause a host of problems that may include personal distress, impaired functioning and disability, pain, or death.
Serious emotional disturbance (SED): A diagnosable mental disorder found in persons from birth to 18 years of age that is so severe and long lasting that it seriously interferes with functioning in family, school, community, or other major life activities.

Serious mental illness (SMI):
A SMI is defined as a diagnosable mental, behavioral or emotional disorder that meets the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and causes functional impairment that limits one or more major life activities. Examples of individuals who meet these criteria include those adults with: mood disorders (major depression, dysthymia, mania); anxiety disorders (panic disorder, generalized anxiety disorder, phobia, post-traumatic stress disorder); antisocial personality disorder, schizophrenia, and other non-affective psychoses.

Serious and persistent mental illness (SPMI): Individuals with the most severe types of Serious Mental Illness and who have the most severe functional limitations can be said to have serious and persistent mental illness (SPMI).

What is a Substance Abuse Disorder?
In this publication, a substance abuse disorder refers to either substance abuse or substance dependence. Substance abuse is the problematic use of alcohol or drugs occurring when an individual’s use of alcohol or drugs interferes with basic work, family, or personal obligations. Substance dependence is a clinical diagnosis that is made when an individual using alcohol or illicit drugs meets at least three of the six
criteria set forth in the DSM-IV for either alcohol or drug dependence including a strong desire to use the substance, a higher priority given to use than to other
activities and obligations, impaired control over its use, persistent use despite harmful consequences, increased tolerance, and a physical withdrawal reaction when use is discontinued. Substance abuse and dependence can occur with the use of alcohol, illicit drugs, and prescription medications.

Sources: Department of Health and Human Services. Healthy People 2010. Chapter 18 – Conference Ed. Mental Health and Mental Disorders. Referenced on the SAMHSA Website. Terminology of Mental Disorders.
http://www.mentalhealth.samhsa.gov/features/hp2010/terminology.asp. Accessed 8-24-05;
World Health Organization. Lexicon of alcohol and drug terms. Available at: http://www.who.int/substance_abuse/terminology/who_lexicon/en/index.html. Accessed 10-3-05.

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