Experts emphasize need to integrate primary care with mental healthcare

Individuals with severe mental illness are more likely to die prematurely than those without — not because of their mental conditions, but as a result of lack of regular medical care and otherwise treatable chronic medical conditions, according to CNN.

People with mental illness often don't get enough medical care for a number of reasons. They may be uninsured or struggle to find physicians who accept their insurance plans, or they may avoid seeking medical care altogether because of stigma or discrimination.

Another issue that has long posed a barrier to healthcare for those with mental illness is a lack of communication and coordination between mental health providers and medical providers. This lack of coordination contributes to medication problems, higher healthcare costs and gaps in care, according to the report.

However, providers have begun taking steps to enhance the coordination of care for people with mental illness by forming partnerships aimed at improving both aspects of patients' health.

"There has been a sea change in attitudes," said Garrett Moran, PhD, project director of the Academy for Integrating Behavioral Health and Primary Care at the Agency for Healthcare Research and Quality, according to the report. "If we are going to bend the cost curve, the integration of behavioral healthcare and physical healthcare is essential."

According to Dr. Moran, the oft employed model of referring patients with mental illness to a primary care physician does not work. For the best health outcomes, patients require close, synchronized monitoring by both types of providers, preferably in the same facility.

For instance, the RAND Corportion's review of 56 programs around the country found that patients who received primary care services at mental health sites had better control over diabetes and hypertension, according to the report. However, obese people and smokers did not show improvement.

Linda Rosenberg, president and CEO of the National Council of Behavioral Health, said people with mental illness often experience difficulty trying to get to a physician because they are often poor, homeless or live chaotic lives.

"The best place to get their physical healthcare is the place where they are getting psychiatric care," she said, according to the report. "They want the same things we do — they want convenience."

Ms. Rosenberg said integration starts with housing primary care and mental health providers in the same office, but to have an impact, they must plan and coordinate care delivery together.

In 2009, the federal Substance Abuse and Mental Health Services Administration awarded $150 million in grants to organizations to promote partnerships that incorporate medical services into mental health clinics. So far 190 organizations have received grants.

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