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

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