A Primer on Integrated Primary Care
Draft 2-15-2010
Historically, mental health treatment has been a specialty service that required patients to get referral and enter a different system of care other than their primary care provider. This has resulted in several problems. First, there is not enough mental health providers, especially in underserved areas. Only about 5% of patients with mental health problems get seen by specialty mental health providers. The stress of this is primarily felt by primary care providers. Second, a stigma was created, because you had to become a “mental health patient.” Of course, this would happen to a variety of health conditions were we to apply the same model. Imagine got to a “Sexually Transmitted Disease” clinic for a routine infection and becoming and STD patient. Imagine going to an Incontinence Clinic for having problems controlling urination and becoming an “Incontinence Patient.” It turns out that many of the ailments that we have as humans would be embarrassing to get care for if we had to enter a spotlight in order to get care. Finally, a disconnection between primary care and mental health care and results in poor to no communication, which is vital for best patient outcomes.
Out of this dismal situation comes a bright solution, integrating mental health services into primary care. Early attempts were to collocate the traditional mental health service at the same site of primary care services. However, this only partially reduced the stigma and some systemic barriers. What is gaining more ground is to have an integrated service that is a part of primary care. The services is consultative and collaborative in nature so that PCPs can hand off patients to BH providers and they can discuss findings and the treatment plan. Most services are handled on site, with some referrals out for specialty care that is not covered in the clinic. The emphasis is on population based care, trying to affect behavioral change to improve the psychological and physiological health of all the patients in the primary care panel.
To find out more visit:
http://web.me.com/nefserrano/PrimaryCarePsychology/Why.html