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New initiatives under way to coordinate mental health, primary care
It's well-documented in research literature that primary -care physicians often miss the signs of common psychiatric illnesses like depression, leading to the avoidable complications that mental health issues add to medical problems. However, some healthcare organizations are hoping to address this issue by better coordinating mental health services with primary care.
Increasingly, it's becoming more common for primary-care practices to integrate brief mental health check-ups with primary-care screenings. Typically, this involves 15- to 30-minute visits that address common behavioral issues such as traumatic stress and depression. Research suggests that such integration of mental and medical care can lower overall health costs by, among other benefits, improving medication compliance and reducing emergency departments.
In the past, mental health has been considered a specialist level of care that requires a referral, and is handled outside of the primary-care visit. However, health leaders are beginning to acknowledge the fact that many problems that present in a primary-care setting may have a mental health component, and that some health problems--such as diabetes--could be worsened by neglect brought on by mental health concerns.
At present, it's more common for these services to be offered by health plans like Kaiser Permanente, and networks like the Veterans' Administration health system, which both offer and finance care. Traditional health plans have resisted paying for even these brief screenings in a primary-care settings. However, we predict their attitude may change if this model proves effective--which seems likely given existing research.
To learn more about this practice:
- read this Philadelphia Inquirer piece
Related Articles:
U.S. mental health spending rising rapidly
Study: Comparative effectiveness research might improve mental health treatment
Study: Mental illness more common than previously projected
Comments
By Beth Boynton, RN, MS | Posted 12:38pm | September 30, 2009
It is great to see this process making its way into the healthcare mainstream and long overdue. If our society invested in the social and emotional needs of individuals the need for medical intervention would drop significantly. Plus, physicians and nurses are in a great position to recommend mental health support for primary and secondary reasons.
Great article, thanks.
Beth Boynton, Author of Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces.
By Scott Macleod, MD | Posted 1:11pm | September 30, 2009
Insurance companies has not been helpful as mental health has been "carved out" of family practice often. As well if a psych diagnosis is used then the payment is often reduced, even if other regular medical diagnosis are included! So often other diagnosis such as fatigue are encouraged by the billing consultants to be used. The use of billing data to make conclusions about care issues is frankly just scary.
So until insurance pays for screening and treating the same as any other medical issue, this problem will continue. Often things that are said such as prevention is good, screening is good, treating is good but when it comes to paying for it, well it just doesn't happen.
Maybe someday it will happen but this discussion has been ongoing for years. I just hope that finaly we are able to treat pts as a whole rather than bits and pieces. Maybe then my skills as a family doctor will be recognized as just as important as those who cut up parts.
By Alexandra Bettencourt | Posted 12:22pm | October 1, 2009
Another easy way to monitor the mental wellness with patients and improve communication with physicians is RememberItNow! http://www.rememberitnow.com
RememberItNow! features a Wellness Journal and Wellness charts where patients can record and monitor their health and mental wellness.
With many more features and report sharing, RememberItNow! is worth a look!
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