Individuals with co-occurring behavioral and physical health conditions experience higher morbidity and mortality, yet little is known about the availability of services for them at behavioral health facilities. Given the evidence that private equity ownership of behavioral health facilities is increasing and that for-profit health care facilities tend to offer a more restrictive range of services than nonprofits, it is important to investigate services offered at behavioral health facilities by type of ownership. This descriptive study of behavioral health facilities in Michigan, New Mexico, Virginia, and all other states combined examines differences in services offered by for-profits and nonprofits with low-cost care.

Why This Matters

Chronic physical conditions, such as tobacco use disorder and metabolic syndrome, are common among individuals with behavioral health conditions, and inadequate management of these physical health issues contributes to their high morbidity and mortality. Fragmented care, where these services are siloed, often leads to poor health outcomes. However, public policy can promote the availability of holistic services, including by supporting Federally Qualified Health Centers and other facilities offering holistic services for people with co-occurring behavioral and physical health conditions.

What We Found

Nonprofits with low-cost care were generally more likely than for-profit behavioral health facilities to provide communicable disease screening, metabolic monitoring, integrated primary care, and tobacco cessation support and to offer services in more languages. For-profit behavioral health facilities primarily treat substance use disorders (SUD), while nonprofits were more likely to treat a mix of SUDs and mental health or primarily treat mental health.

Despite generally being more likely to offer services that are important for people with these co-occurring conditions, our study suggests that these patients nevertheless likely experience gaps in care at nonprofits with low-cost care because many of these facilities do not offer one or more critical physical health services we examined, including testing for communicable infections (such as hepatitis B, hepatitis C, HIV, or sexually transmitted infection), tuberculosis screening, metabolic syndrome monitoring and testing, nicotine replacement therapy, or nonnicotine tobacco cessation medication.

How We Did It

We relied on the 2022 National Substance Use and Mental Health Services Survey to produce descriptive statistics showing the extent to which nonprofits with low-cost care and for-profit behavioral health facilities offer important services for people with co-occurring physical and behavioral health conditions.