If you go to your doctor for a healthcare issue or an annual checkup, and they treat you for a physical healthcare issue – one part of the process should be related to your mental health also. This is becoming more commonplace but we have more work to do.
The same is true for the reverse. When you seek treatment for a mental health condition, you may have a physical medical issue related to that condition that may not be diagnosed in the behavioral health facility.
There has been extensive research showing that there should be focus on treating and diagnosing mental health problems in primary care facilities. When primary and behavioral care are integrated, a gap in treatment is closed.
But it’s more.
Mental and physical health are completely entwined. Closing the gap between mental and physical healthcare saves lives. Staying mentally and physically fit helps the entire society. Closing this gap means incorporating mental health care into primary care settings and primary care into mental health settings. While there is no one single solution or model yet, there are things that primary care facilities can do to start pushing the idea of an integrated model to their clients and vice versa.
The Problem
Nearly 40 million American adults have untreated substance use disorders or mental health conditions like depression. And many don’t seek treatment.
Whether they think they don’t need it, don’t know where to find it, or don’t want to be seen seeking treatment because of existing stigmas, leaving these issues untreated can lead to other health complications such as drug overdoses. These new complications then raise healthcare costs and put the life of the individual in danger.
While mental health conditions can often lead to a medical condition, the same is true for the opposite. Untreated medical conditions can often result in an individual self-medicating or cause depression when the symptoms become overwhelming.
It’s well known that mental and physical health impact each other, but the healthcare system has historically chosen to treat them separately. This can cause frustration, add more time to treatment, add more costs to treatment, and lead to negative outcomes.
Whether one causes the other or the other way around, many medical professionals are recognizing the importance of treating the two together by integrating primary and behavioral health care.
The Solution
The solution to the problem of piecemeal care is integrated care.
The Hogg Foundation for Mental Health provides a definition: “Integrated health care is the systematic coordination of physical and behavioral health care. The idea is that physical and behavioral health problems occur at the same time. Integrating services to treat both will yield the best results and be the most acceptable and effective approach for those being served.”
Here are a few places to start incorporating integrated care even if you don’t have an integrated care facility.
- Distribute information: If you’re a primary care facility, distribute information about mental health treatment and its importance in maintaining physical health.
- Communicate: Start conversations with clients about the importance of both types of care. Talk to other facilities about the types of care they are offering. If you’re in primary care, provide contact information to mental health facilities. Start small, but start a conversation.
- Education: Provide training and education for your professionals on how to address and recognize mental health issues in a health care setting.
- Mental health screening: If you’re a primary care facility, begin by offering mental health screenings for your patients coming in for medical issues.
The Benefits
While we’ve touched on some of the benefits of an integrated model of care, the strengths continue to present themselves.
Additional benefits of providing an integrated approach include:
- Access to care: Two-thirds of primary care physicians report not being able to access outpatient behavioral health for their patients. When clients in primary care offices present with behavioral health issues this often leads to challenges in finding those clients additional mental health care. Why? Because of a shortage of mental health providers, obstacles in health plans, and lack of coverage. If this care was provided on site, this would eliminate barriers created by access to care especially because 80% of people with a behavioral health disorder will visit a primary care provider at least once a year.
- Follow-through: 30-50% of patient referrals from primary care to an outpatient behavioral health clinic do not make the first appointment. Clinicians can take the step of referring a client for behavioral treatment but for many reasons, they may never actually make that first appointment if doing so is inconvenient.
- Cost: Use of health care services decreased by 16% for those receiving behavioral health treatment, while it increased by 12% for patients who were not treated for their behavioral health care needs. Treating all aspects of health will create overall stronger individuals. In addition, depression treatment in primary care had $3,300 lower total healthcare cost over 48 months.
For the clinician or physician, the benefits are as plentiful as they are for the patient. When they were polled, 97.4% were satisfied with having access to an integrated psychologist. They not only believe that integrated care directly improves client care, but that it is a needed service and helps deliver their best care to their clients. 90.1 % reported having an integrated psychologist reduced their personal stress level.
When mental and primary care are integrated, our overall health is improved, healthcare costs are lowered, our entire society benefits and clients lives can be improved and possibly saved.