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Access & Affordability: Exploring SMI Coverage & Trends In The U.S. Behavioral Health System

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Access & Affordability: Exploring SMI Coverage & Trends In The U.S. Behavioral Health System

Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illness is particularly concentrated among those who experience disability due to SMI.1 It is estimated that 21% of adults in the United States are experiencing some type of mental illness while 5.5% are experiencing SMI which is equivalent to over 50 million Americans and 14.1 million respectively.1,2,3

In this webinar, OPEN MINDS and PsychU will focus the healthcare lens on SMI coverage and affordability over the better part of the past decade.


Goals of the webinar include:

  1. Discuss the serious mental illness coverage research from the OPEN MINDS
  2. Walk through the benefit structure health plans currently cover for individuals with SMI and the increase in future coverage.
  3. Review the implications of the Trends in Behavioral Health 2023 Guidebook results for the future of SMI coverage and affordability impacting clinical models and outcomes.
  1. Mental Illness. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/mental-illness
  2. Reinert, M, Fritze, D. & Nguyen, T. (October 2022). “The State of Mental Health in America 2023” Mental Health America, Alexandria VA.
  3. Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report.



Cathy Gilbert

Senior Associate, OPEN MINDS, former Vice President II, Network Development at Magellan Healthcare Inc.

Cathy Gilbert brings over 20 years of health care industry experience to the OPEN MINDS team. Ms. Gilbert currently serves as a Senior Associate at OPEN MINDS. Her areas of expertise include advanced project leadership skills, training development, health care processing systems, policy development, and implementation to ensure compliance with accreditation requirements.

Before joining OPEN MINDS, Ms. Gilbert served as the Vice President II, Network Development at Magellan Healthcare Inc. During her role there she directed a national team to support network development and provider relations for health plans, employers, Medicare, and Medicaid. Also, Ms. Gilbert led a network operations team responsible for credentialing, provider data maintenance, rate management, and contract administration for all networks. She supported responses for sales opportunities and represented the network at client and sales meetings.

Previously, Ms. Gilbert served as the Assistant Vice President of Network Operations with Beacon Health Options in Latham, NY. In this role, she was responsible for overseeing provider file maintenance, provider file configuration, and provider credentialing. Ms. Gilbert also implemented an audit function to improve provider file accuracy and led a process to reduce the initial file credentialing backlog by 45%.

Prior to her work with Beacon Health Options, Ms. Gilbert served as the Vice President of Provider Relations at Beacon Health Options/ValueOptions Inc. in Wixom, MI. Ms. Gilbert led and participated in internal and external committees including credentialing, policies and procedures, provider satisfaction, provider stakeholders, and quality management. She also led network development projects for new client implementations and network expansions. Ms. Gilbert designed and implemented a departmental training program for new and current staff.

Ms. Gilbert earned her Master of Science Administration, Health Services at Central Michigan University. Prior to earning her master’s degree, Ms. Gilbert earned her Bachelor of Science, Social Work at Eastern Michigan University.

Sharon Hicks, MSW, MBA

Senior Associate, OPEN MINDS, former Chief Operating Officer for Community Care Behavioral Health.

Sharon Hicks, MBA, MSW, has more than 20 years of experience in the health and human service field. She has extensive expertise and a wide range of experience in health plan management, clinical operations management, and technology. A recognized thought leader among her peers, Ms. Hicks is a regular keynote speaker at industry conferences and association meetings, as well as an author of hundreds of articles and resources for professionals in both clinical and executive roles.

Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system. She served as the Chief Operating Officer for Community Care Behavioral HealthUPMC’s managed behavioral health organization responsible for $800 million in annual revenue. At Community Care, Ms. Hicks was responsible for all aspects of the organization’s operations, including fiscal, information systems, the claims processing department, and the design of clinical systems. She also managed the day-to-day operations of human resources, facilities, purchasing, and security.

Ms. Hicks also served in a variety of tech leadership roles for UPMC. In 2002, she was appointed as the Vice President of Technology Strategy for the UPMC Insurance Services Division before becoming the Chief Executive Officer of Askesis Development Group, a leading provider of electronic health record software for behavioral health and social service organizations. In this role, Ms. Hicks was responsible for the growth and profitability of the company and the direction of software development. In addition, Ms. Hicks was the President of U Squared Interactive, a UPMC-owned organization with the exclusive United States rights to Beating The Blues – the renowned computerized cognitive behavioral therapy solution for treating anxiety and depression.

Ms. Hicks started her impressive career as a psychiatric social worker and an Assistant Director of Social Work. Prior to her promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, Ms. Hicks managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.

Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburgh in Pittsburgh, Pennsylvania. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology from Point Park College, Pittsburgh, PA.

Arden Arslanyan, PharmD (OPDC)

Managed Market Liaison

Arden Arslanyan, PharmD, is a Managed Market Liasion with Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC). Arden has held various clinical roles within Express Scripts supporting Medicare, Commercial, and Workers’ Comp lines of business. He attended Nova Southeastern University and completed a post-doctoral fellowship program in medical information in conjunction with Rutgers and Janssen Scientific Affairs.

Cathy Gilbert and Sharon Hicks are paid consultants of Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC). Arden Arslanyan is an employee of Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC)


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