Integrating Physical & Psychiatric Care

Integrating Physical & Psychiatric Care

Think back on when a friend or loved one has had a significant health setback. When we speak with that friend, we often ask for the physical details of their condition and then inevitably, we pose a variation of this question, “How are your spirits?” Why do we ask that? Well, it seems that we all have an intrinsic idea that the health of mind has an important correlation to the well being of the physical self. Even with this seemingly recognized connection, medical health care and mental health care have historically been separated. As the Hogg Foundation for Mental Health points out, “The physical health care system is not set up to address behavioral health problems, and the mental health and substance abuse treatment systems are not set up to address medical problems.” Until now. Lately, there has been a push for collaboration between the two disciplines. 

Why now?

APNA, or American Psychiatric Nurses Association, suggests that the effort to combine mental and physical health is due to a unique combination of events. “National health care reform and mental health parity legislation, as well as electronic medical records (EMRs), have set into motion systems of care that recognize and even require the collaboration of mental health care within medical settings.”

What happens if we continue with the siloed approach to care?

The frightening truth is, “When psychiatric disorders are not addressed in people with chronic medical illness, they have worse outcomes. Patients with chronic medical conditions who also have depression are less able to take care of their illnesses or follow prescribed treatment. These patients feel and function worse than patients with the same medical illnesses who do not have depression. They are more likely to die from their illnesses than those patients without depression.” Additionally, the costly state of health care in our country is a major concern. The integration of care helps to reduce treatment fragmentation, excess referrals and inefficient allocation of resources – all of which ratchet up the costs for care. Alain Enthoven, the Marriner S. Eccles Professor of Public and Private Management, Emeritus, at the Graduate School of Business at Stanford University says integration is, “…a complex notion, but one that promises to keep health care costs under control while increasing the quality of care for the patient.”

What does Integrated Care Look Like?

The American Psychological Association describes Integrated Care as bringing “…together health-care professionals who work in teams to treat the whole person. Physicians, psychologists, nurses and other providers work in tandem to diagnose physical and psychological health problems, to plan and provide treatment, and evaluate whether that treatment is effective.” This description leaves room for interpretation, so it’s important to point out that there isn’t any one model for integration, and implementation that can look different depending on insurance providers, physician location and philosophy. Some models include behavioral care within the primary care setting, primary care within the behavioral health care setting, and more.

Benefits of Integrated Care

Patients can expect better overall health outcomes when both their physical and mental health is looked at as a whole. However there is a litany of other benefits that come with an integrated health approach. The Camden Group, which researched the issue, lists increased collaboration among physicians, improved efficiency, integrated systems, improved care management and integrated continuum of care among others as benefits to the integrated care approach.

For people that have a multitude of health care needs, it’s clear that the trend toward integrated health care is an exciting and promising new development in the industry. One that hopefully provides positive responses when we ask friends and family, “So, how are your spirits?”