Millions of Americans suffer from both mental and medical health conditions, so integrating both types of care can help improve treatment, outcomes and stigma reduction.
Integrative behavioral health can take place either locally or remotely through shared treatment plans, with payers and providers offering incentives to facilitate integration.
Behavioral Health Services
Depression, addiction and mental illness often co-occur with medical disorders like heart disease and asthma; yet patients experiencing significant behavioral health challenges tend to be less compliant with treatment plans for their medical ailments.
Integrative care can enhance patient engagement, lower stigmatism and ensure health care providers treat both physical and behavioral conditions simultaneously. Furthermore, integrated care helps ensure patients with behavioral health needs have access to all necessary health services.
Integrated care models range from less intensive models, such as consulting behavioral health clinicians or using screening, brief intervention and referral to treatment (SBIRT) approaches in medical settings, to fully integrated models in which behavioral health practitioners work directly within primary care practices or, if they can’t physically be present on site, seamlessly embedded within multidisciplinary teams, procedures and information systems of those practices. SAMHSA-HRSA offers numerous resources for all these levels of integration as well as billing and financing solutions.
Social Services
Integrative health care offers patients multiple advantages by meeting both their physical and social health needs. A medical-social service model may assist patients in adhering to treatment plans for chronic physical conditions like diabetes and hypertension that co-occur with mental illness disorders.
Poverty can have devastating health outcomes and be the source of both poor mental health and limited access to treatment services. Disasters have an especially detrimental impact on people with lower socioeconomic status due to resources they lose as a result, compounding with prior trauma and stressors like substance abuse that are already present.
Integration between physical and behavioral healthcare services brings many advantages, from improving outcomes to decreasing stigmatization. Integration should therefore be at the core of any health system’s strategy; PCMH standards expect PCMHs to support patients’ mental healthcare needs while accountable care organizations and multispecialty medical groups contracting with payers for bundled payments are already expected to integrate physical and behavioral healthcare services seamlessly.
Physical Health Services
How we care for our bodies affects both physical and mental wellness. Physical wellness encompasses healthy lifestyle behaviors like exercising regularly, eating healthily and refraining from harmful habits – these habits can help us feel better, extend life expectancies and reduce medical treatment costs. Creating these routines will enable us to feel healthier overall as well as prevent mental illnesses that require costly medical intervention.
Integrated healthcare provides comprehensive services that treat both physical and behavioral health. This may mean integrating mental health professionals directly into primary care visits or using telepsychiatry; either way, this approach can foster early intervention to treat co-occurring disorders more efficiently, reduce stigmatization and potentially save lives.
To enable these improvements, public and private healthcare systems must collaborate. This collaboration can be enhanced with policies like same-day billing, cross-training of medical and behavioral health staff and value-based contracts that include whole person outcomes.
Community Engagement
Community engagement is an approach used to involve local communities in policy making, delivery and management of projects that address social determinants of health and reduce inequalities. Community engagement enlists people’s participation and empowers them by providing them with information about policies that impact them directly, showing their contributions’ worth through feedback mechanisms, and developing trust between government organizations and communities for the long haul.
Community involvement takes many forms, from simple consultation to community control. According to a rapid review of studies on subjective experiences of engagement for individuals, most ‘engaged’ individuals report benefits such as physical and psychological health improvements, increased self-confidence and esteem levels, personal empowerment as well as enhanced social connections.
However, for certain individuals there can be unintended negative side-effects when planning engagement initiatives – including fatigue and stress from participating. Community engagement providers or managers must be mindful of such potential outcomes and try their best to support participants where necessary.
