Should Mental Health Be Integrated Into Primary Care?
Integrating health services from separate industries may be done to cut administration costs due to common resources. However, some people may feel that integrated services do not completely address their needs and can cause a drop in the quality of mental healthcare. Businesses may separate mental health or lump it into other categories, aiming for efficiency and cutting specialty care.
Incorporating mental health services into primary care settings
The disadvantages of integration
The integration of mental and physical healthcare often involves uniting efforts between physicians, social workers, nurses, and mental health therapists. This team of care providers may coordinate with each other to holistically treat clients from the same clinic or healthcare organization. Below are a few potential disadvantages to this system.
Efficiency over quality of health care services
Although it may sound beneficial in practice, some integration systems value efficiency over quality. After a client goes to one department, they may be passed on to another without having quality one-on-one time with providers. This process may cause unnecessary delays in treatment and can also mean that clients are passed around repeatedly.
This cycle of referrals, assessments, and waiting can cause clients to become more unstable or experience worsening symptoms. To get treatment, they may end up approaching multiple departments in the hope of expediting the process. However, some integration systems offer mental health services within the same appointment. Full-service integration and quality of care can be more productive, allowing clients to receive mental health services on the same day without being transferred or referred months out.
Inefficiency of patient services
When clients visit multiple departments, it may feed an incorrect assumption that there is rising demand for those services. However, passing a client around can be ineffective. They may be seen by the wrong department first, passed on, and then escalated. Clients may then be accused of using services too often or “looking for problems” when they might have had better luck being referred to the proper location first.
Cost of integrating mental health and primary care
Integrative services can require multiple appointments, consultations, and visits with healthcare professionals. The cost may add up quickly, especially if the client does not have insurance. In these cases, clients may pay for consultations they don’t need.
Should mental health be integrated into primary care settings?
Integration may have several benefits, including allocating multiple resources under one roof. By integrating, clients gain mental health services alongside physical health support. Having multiple professionals to consult with may offer a higher quality of care and a chance of disease prevention, medication management, and diagnosis support. Below are a few of the other benefits of integration.
Availability of services
Integrated health systems often have multiple providers in one location, so clients can make appointments with multiple individuals without making new insurance claims or signing up for a consultation with a new doctor elsewhere.
All inquiries are integrated by processing clients into multiple systems through one appointment, improving patient care. Exclusive mental healthcare facilities may not offer physical health options, medication management, or case management. An integrated facility can offer more options, giving clients a choice over the type of care they receive.
Common records
With an integrative facility, client records are provided to the entire care team, with consent from the client. These records may involve medications taken, hospital visits, diagnoses, and billing. When a client meets with their therapist, the therapist can ask them about recent hospitalizations or medication changes. When they meet with a psychiatrist, the psychiatrist can look at how many sessions the client has had with a therapist. Through a release form signed by the client, providers can also exchange notes and treatment plans with each other.
Benefits
Some integrative health centers offer constituents benefits, such as parking, a special waiting area, or quicker service. Some locations may offer services at one monthly cost for those without health insurance, which could be cheaper than paying for multiple providers. However, this factor can depend on the location.
How to find personalized support
If your primary care provider has referred you to an integrative health center and you prefer personalized care, several options are available. If you’re not looking to add more in-person services, you can try therapy through an online platform like BetterHelp. You and your online therapist can communicate anytime, day or night, through chat sessions, video chat, or texting therapy without the need to be funneled through a complicated portal system that often characterizes integrated services.
The effectiveness of online therapy for treating mental disorders
Studies have proven online therapy as effective as in-person therapy, with the added benefits of increased availability for those who live remotely or struggle to travel easily or pay the fees of an in-person therapist. In a study published in the American Journal of Psychiatry, psychiatrist Haim Weinberg found that many of his clients who shifted from in-person to online therapy felt more comfortable opening up online because of the barrier of the screen and the comfort of being in their own space.
Takeaway
What is an integrated approach to patient care?
Integrated mental healthcare (sometimes called integrated care) is a comprehensive and holistic method that combines physical and mental health services within one setting. This approach recognizes that biological, psychological, and social factors contribute to a person's overall health and well-being. An integrated perspective helps address the root causes of mental health issues and can lead to more effective treatment.
Here are some key components of an integrated approach to mental healthcare:
Collaborative Care Teams
Integrated mental health services typically involve a team of healthcare professionals, including primary care providers, mental health specialists (such as psychiatrists, psychologists, and social workers), and other specialists like nutritionists and addiction counselors, if applicable.
Providers within an integrated system coordinate and remain in contact to ensure that patients receive comprehensive, cohesive, and well-rounded care. Integrated electronic health record systems facilitate communication and providing of information among healthcare providers so that everyone involved in a patient's care can obtain relevant information.
Screening And Assessment In Primary Care Visits
Patients are routinely screened for mental health issues during primary care visits, allowing for early detection and intervention. Likewise, physical health concerns may also be assessed during mental health visits. Mental health services, such as therapy and counseling, are made available within primary care settings. This can include on-site therapists, behavioral health consultants, or telehealth services.
Patient Involvement
Patients are actively involved in their care, collaborating with their healthcare team to make informed decisions about their treatment and management plans. They're also provided with education and resources to better understand the relationship between physical and mental health and to support self-management and prevention.
Proactive, Preventative Treatment
Preventative measures such as lifestyle modifications and stress management are used for early intervention to reduce the risk of mental health issues and physical health conditions.
Should mental health be integrated into primary care? Benefits and applications
An integrated approach to mental healthcare aims to break down the traditional barriers between mental health and primary care. It provides more holistic, patient-centered, and efficient care, ultimately improving outcomes for patients with mental health concerns. It recognizes that the mind and body are interconnected, and addressing both aspects is essential for overall health and well-being.
The integrated behavioral healthcare approach can be used in many capacities. It may provide an individual's healthcare team with the information needed to formulate a preventative treatment program. It can help patients control how they approach their health, including through lifestyle changes and self-care management. Some programs expand to include social services like career counseling, life skills, relationship management, and more.
What is an example of an integrated health care model?
According to the American Psychological Association, the two most commonly used models of care integration are:
Primary Care Behavioral Health Model (PCBH)
A population-based model that includes a licensed mental health professional who operates as the core constituent of the primary care team. This individual's job is to coordinate and implement early intervention strategies and current treatment for a patient's mental healthcare concerns, physical health concerns, and ongoing conditions throughout the patient's life. This approach is used within a pediatric, adult, and geriatric context.
Collaborative Care Model (CoCM)
The CoCM model typically focuses on adult care management and comprises a primary care provider, a care manager such as a social worker or psychologist, and a psychiatrist consultant who may integrate psychopharmacological approaches with traditional psychotherapeutic methods. This model can also include supplemental services such as problem-solving and communication skills training for people with chronic mental health issues like major depression, PTSD, and bipolar disorder.
What are common types of mental health care providers?
There are many types of mental health service providers with unique roles and skill sets that contribute to a patient's needs within an integrated mental healthcare model:
Psychologists
These professionals typically have a doctoral degree in a specialty area such as clinical psychology, education, or counseling and are trained in specific forms of psychotherapeutic methods. This individual will interview the patient, administer psychological evaluations and testing, and diagnose and develop a mental health treatment plan.
Therapists And Counselors
Counselors and therapists often have a master's degree with a specific focus in which they'll acquire licensing for and apply within a clinical setting. Some examples include marriage and family therapy, counseling for substance use disorders, care for children, and senior care.
Clinical Social Workers
These professionals may have targeted degrees and training to evaluate a patient's mental health and apply therapeutic techniques based on their individual needs. Social workers often work within advocacy services and case management for those who need specialized help.
Psychiatrists, Psychiatric Nurses
Psychiatrists are doctors who can diagnose mental health conditions, provide therapy, and prescribe medications as needed. Psychiatrists may also complete additional training and education for treating individuals with substance use disorders, children and adolescents, and older adults.
Psychiatric nurse practitioners typically work with guidance from a psychiatrist in different capacities. They are trained to assess patients to provide a diagnosis and therapeutic strategy for treating mental health conditions. Depending on the state's requirements, they may also prescribe and monitor pharmaceutical treatments.
Who is involved in treating mental health disorders?
In an integrated approach, all medical caregivers are involved in mental health services for the patient in some way.
Primary care physicians and mental health professionals often coordinate, offering psychological and physical treatments that complement each other to promote the patient's overall health. If a patient needs specialized treatment, such as in the case of a substance use disorder or eating disorder, the team may work with a doctor specializing in such categories.
Regardless of how many caregivers are on the team, integrated services are also about empowering the patient to take an active role in their healing and health. This may include self-care strategies and group support sessions. If they have difficulties in relationships with their families, the patient may be referred to a marriage and family therapy professional.
What is an example of behavioral health treatment?
Mental health treatment can be practiced in an in-patient setting, such as a hospital or residential treatment facility, or an outpatient, non-residential clinical setting.
Mental health professionals most commonly use methods like psychotherapy, psychopharmacology, and alternative therapies typically combined for a comprehensive treatment plan. In some cases, psychologists work with a psychiatrist or doctor if they feel brain stimulation therapy is beneficial.
What are integrated activities?
Some patients require activities of daily living (ADLs) as part of their integrated treatment plan to help with:
- Cognitive skills like memory, problem-solving, and understanding directions.
- Social skills such as avoidance and anger management, interacting with others, and communication.
- Personal management skills such as how to set and manage goals, maintain personal hygiene, and cope with domestic challenges like budgeting and caring for a home.
Common ADLs used as a tool in integrative mental health include, but aren't limited to:
- Housekeeping, cooking, and maintenance tasks.
- Personal hygiene and grooming care.
- Managing money and paying bills.
- Shopping for groceries, clothing, and other necessities.
- Self-care tasks including eating, sleeping, physical activity, and social engagement.
- Using the internet, phone, and other directories to run errands.
- Learning to use public transportation.
- Care for a pet or others.
What is the simple meaning of integration?
The Merriam-Webster Dictionary defines integrated as: "to form, coordinate, or blend into a functioning or unified whole," "to incorporate into a larger unit," or "to unite with something else."
- Previous Article
- Next Article