Most Health Centers Provide Some Behavioral Health Services to Patients With Substance Use Disorder, Despite Facing Challenges That Limit Comprehensive Treatment

Why OIG Did This Review

• HRSA-funded health centers play an important role in national efforts to address substance use disorder. For many communities, health centers serve as the first and primary access point for their health care needs.
• Health centers serve over 31 million people, and HRSA estimates that 1 in 6 health center patients could benefit from substance use disorder services.
• Effective treatment for substance use disorder includes one or more types of behavioral health services:
  • Mental health treatment includes therapies and/or medication to address mental health disorders, such as bipolar disorder, that may co-occur with substance use disorder;
  • Drug counseling includes one-on-one, family, or group counseling or other therapies that address patients’ specific drug use and misuse; and
  • Medication for opioid use disorder (MOUD) includes three FDA-approved drugs—methadone, buprenorphine, and naltrexone—to treat opioid use disorder.

What OIG Found

In 2022, 90 percent of health centers provided at least one type of behavioral health service to patients with substance use disorder, while 56 percent offered comprehensive treatment. Specifically, 88 percent provided mental health treatment, 69 percent provided drug counseling, and 72 percent provided at least one type of MOUD.

More than one-third of health centers experienced challenges with providing behavioral health services through external providers.

Health centers used a variety of professional types and delivery models to provide behavioral health services but reported that workforce and financial challenges impeded their efforts.

What OIG Recommends

To improve access to behavioral health services for people with substance use disorder, we recommend that HRSA take additional steps to help health centers overcome barriers that impede provision of both drug counseling and MOUD.

HRSA agreed with the spirit of OIG’s recommendation but did not state whether it concurred with the recommendation.