The "Why" of Integrated Primary Care
This week, I started my graduate certificate for Integrated Behavioral Health Management with Arizona State University. So far, it is giving me exactly what I intended: building on my years of experience in healthcare and technology, but diving deeper into the operations of primary care and behavioral health.
Along the way with this program, I’ll be posting and sharing in order to contribute to the broader knowledgebase. I welcome your comments and feedback! My first assignment was a discussion board summarizing the “why” of integrated primary care and, as a member of the management track, exploring how I might apply the learnings of this program to my career.
Behavioral health is an under-utilized, yet vital, service for total wellbeing and whole-person care. Americans are in crisis when it comes to their mental health, but we are also having a moment of appreciation for the importance of mental health and seeking assistance. According to Mental Health America (MHA), nearly 50 million Americans experience mental illness, but 27.4% of those adults report an unmet need for treatment (Reinert, 2021). One report found nearly one in five U.S. counties had unmet needs, showing both a professional shortage and an uneven distribution of available providers (Thomas, 2009).
Technology is a key tool to help resolve shortage, distribution, and utilization. Telehealth use has stabilized since the beginning of the COVID-19 pandemic at 38X pre-pandemic rates (Bestsennyy, 2021). This consistent willingness to connect with providers outside of a traditional setting removes access barriers to help patients get the support they need. Enabled by telehealth and integrated primary care, we can help the 30-50% of patients who miss their first appointment with a mental health professional (Corso, 2016) by eliminating the need to call off work, find childcare, and get transportation. While most primary care providers have training in mental health care, their views on the importance of these complaints when compared to physical health can vary and they are not always prepared to detect these issues (Corso, 2016). An integrated primary care approach is also an opportunity to prevent burnout for the 63% of physicians who say that stress is increasing (Bodenheimer, 2014). Having behavioral health professionals at the ready, enabled with modern technologies, offsets systemic burdens on patients and care teams to improve their experiences.
When it comes to my goals for this program, I would like to effect change in the way we view behavioral health services. Rather than categorizing behavioral health as an intervention for a problem, we start to view it as an act of prevention. In the same way that we promote annual wellness visits, let’s institute a standard of care for annual mental wellness with quality metrics to impact population health.
References:
Reinert, M. F. (2021). The state of mental health in America 2022. Mental Health America. https://mhanational.org/sites/default/files/2022%20State%20of%20Mental%20Health%20in%20America.pdf (Links to an external site.)
Thomas, K. C. (2009). County-level estimates of mental health professional shortage in the United States. Psychiatric Services, pp. 60(10), 1323-1328.
Corso, Hunter, Dahl, Kallenberg, and Manson (2016). Integrating behavioral health in the medical home: A rapid implementation guide. Greenbranch Publications.
Bestsennyy, O, et al. (2021, July 9). Telehealth: A quarter-trillion-dollar post-COVID-19 reality? McKinsey & Company. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality#:~:text=COVID%2D19%20has%20caused%20a,to%20replace%20cancelled%20healthcare%20visits (Links to an external site.).
Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: care of the patient requires care of the provider. Annals of family medicine, 12 (6), 573–576. https://doi.org/10.1370/afm.1713