The Benefits of Integrating Behavioral Health into Primary Care

From the 2015 Clinton Foundation’s Health Matters Summit.

Adults in the U.S. living with serious mental health conditions die on average 25 years earlier than others, largely due to treatable medical conditions. It’s clear that mental and physical health are intertwined, and care for both should be linked together within health care delivery systems.

Fortunately, health experts are starting to recognize this, and implement strategies to combine mental and physical healthcare.

At the end of January, the Clinton Foundation held its annual Health Matters Summit in Indian Wells, Calif. The summit is an annual event that showcases what the Clinton Foundation’s Health Matters Initiative and its strategic partners are doing to create systemic health improvement throughout the U.S.

This year included a panel hosted by Dr. Gail Saltz, M.D., and included insights from Mohini Venkatesh of the National Council for Behavioral Health, John MacPhee of the Jed Foundation and William Emmet of the Kennedy Forum. The focus was on integrating mental health services into primary care: in effect, turning local healthcare offices into a one-stop shopping experience:

“When you talk about mental health, we really are talking about people with cardiovascular disease, diabetes, COPD, with asthma,” said Saltz at the event. “Because chronic illnesses absolutely cause mental health issues, and mental health issues make those chronic illnesses worse, we have to start talking about that in an integrated sort of way.”

In addition, integrating therapists into a primary health care setting could ease the concerns of people worried about the stigma of receiving psychological care. Emmett also proposed the usage of a Tel-Med-type program that would allow physicians to bring a mental health provider into a conversation with a person who is there in the doctor’s office.

Another practice model discussed included training college community leaders on how to screen for the signs of depression, thus integrating services on campuses. According to MacPhee, 80% of students who died from suicide never even visited the counseling center on campus, but had been to the health center.

Following the panel discussion, the audience discussed ideas for improving mental health care. Linda Evans, associate administrator of Business Development at JFK Memorial Hospital in Indio, Calif., spoke about a model in Texas where psychologists and physicians were teamed up to provide immediate intervention for patients showing signs of depression or other behavioral health issues. However, the common problem was sustainable funding.

Locally, Evans suggested a possible collaboration between the medical community and some of the valley’s many nonprofit agencies that work with stroke, Alzheimer’s, cancer and other individuals and their caregivers.

Ultimately, the common thread behind each of these proposals is communication, and not just between doctor and patient, or between healthcare providers. The more open the public is to discussing mental illness, the harder it is to stigmatize those living with it. Towards the end of the panel, MacPhee made the following plea to the audience to “own” mental illness:

“[If] every individual can own it, where we all talk about it and we can all admit it, we can really accelerate the removal of the stigma and prejudice around it,” said MacPhee. “This is an issue that affects all of us.”