Bridging Gap Between Medical, Mental Health Care
By Anna Gorman
Thu, Mar 3 2016
Even on her worst days, Tracy Young goes to her appointments at the San Fernando Mental Health Center. The counseling and medication, she says, keep her depression and schizophrenia at bay.
“I come here faithfully,” said Young, 50. “I have to come here or I be feeling I just want to give up.”
Young isn’t nearly as religious about her physical health, despite painful arthritis, a persistent backache and a family history of cancer. Until this month, she hadn’t seen a medical doctor in more than three years.
People with severe mental illnesses are more likely to die prematurely than those without, and it’s often from treatable chronic diseases — in part because many, like Young, don’t receive regular medical care. They may be uninsured or unable to find doctors who take their insurance. They may be reluctant to seek care in traditional medical offices because of stigma or discrimination.
Even when they do have medical appointments, their doctors rarely communicate with their mental health providers. Experts said the lack of coordination can lead to medication problems, higher health costs and gaps in care.
Now, though, providers are beginning to bridge the gap between medical and mental care, forming partnerships aimed at improving patients’ physical and mental health, and reducing costs at the same time. Such holistic projects are underway in numerous states, including California, New York, Washington, and Florida.
“There has been a sea change in attitudes,” said Garrett Moran, who directs an academy on the integration of behavioral health and primary care for the federal Agency for Healthcare Research and Quality. “If we are going to bend the cost curve, the integration of behavioral health care and physical health care is essential.”
Moran said the old model — simply referring patients with mental illness to a primary care doctor — doesn’t work. Instead, the patients need close, coordinated monitoring by both providers.
The increased collaboration is driven in part by the Affordable Care Act, which made more people eligible for mental health services and funding for improving coordination of care.