Once upon a time, mental health issues were rarely discussed, but in light of many high-profile criminal acts, those discussions are gaining acceptance. Mental health is considered an entirely different entity than physical health, but research increasingly shows that integrating the two could result in some fairly substantial benefits.
How Would Your PCP Treat Mental Health?
We’re all used to our doctor taking our weight, measuring our blood pressure, and asking us to open up and say “ahh.” Mental health is rarely addressed, but if it were, you’d be asked questions pertaining not only to diet, exercise and lifestyle choices, but also regarding your mental state. Behavioral health counseling would become a routine component of your physical health care and would allow you to manage your own medication use, nutrition and exercise. As great as this sounds, there would be many obstacles to overcome before your primary care physician could reasonably be expected to address your mental well-being.
Simply expecting your doctor to rattle off a series of questions fails to take into account all that is required behind the scenes, everything from billing and coding to electronic medical records systems and care management platforms…not to mention the fact that your PCP would need to have a thorough understanding of behavioral health clinic guidelines and standards of care, and in-depth knowledge of the various social support services available to patients within the community. Not all doctors are comfortable with the idea of integrating mental health care into their practices; doing so would require a steep learning curve for everything from assessments and diagnoses to medications and treatments, and the cost wouldn’t be cheap.
This doesn’t mean integration is impossible or shouldn’t be attempted; it’s an important and admirable goal with many potential long-term benefits. We would have to focus on overcoming roadblocks that include:
- As the nation’s healthcare system evolves, incentives—especially financial—for integrating mental health into primary care are needed to encourage providers to adopt new patient care models. In New York, the state’s Office of Mental Health is creating incentive structures for primary care providers to utilize the Collaborative Care Medicaid Program, which helps offset the costs involved in behavioral healthcare.
- Participation in financial programs such as New York’s is subject to a number of rules and regulations. Practices must meet certain goals and commit to using patient registries in order to receive the best rates. The startup costs alone for putting in place the necessary infrastructure make it a difficult sell for many smaller practices.
- Lack of empowerment. Many primary care providers are resistant to change because they simply aren’t aware of how beneficial integrating mental health care into their practices could prove. Educating them and providing technical assistance can help shift their attitude toward a more pro-behavioral health stance.
Integrating mental health care into primary care practices won’t happen overnight. Getting there will take work, but the benefits are too good to ignore.