One out of five adults with mental illness have a co-occurring substance use disorder and 68 percent of adults with a mental illness have one or more chronic physical conditions (Statistics gathered from the Substance Abuse Mental Health Services Administration www.SAMHSA.org). The chronic health conditions that tend to co-occur with mental illness include high blood pressure, smoking, heart disease, diabetes, obesity and asthma.
Oftentimes, people who suffer from a mental illness are not treated in a respectable manner when they reach out for help for physical issues. Many consumers in Millennium’s Voice of the Consumer groups have relayed stories of waiting room times exceeding one hour, frustrations with being “looked down upon” in several professional offices, and a general aversion to visiting any health care facility.
Years of mistreatment and mistrust must be broken through in order to assist patients with receiving the best possible health care. One solution lies in an integrated care model, and specifically behavioral health integration. For those consumers who have a severe and persistent mental illness, it is imperative that they receive care in a place they feel safe, secure and comfortable. For many, this may be right at the behavioral health office that they have come to rely upon for either substance use disorder and/or mental health issues.
Millennium is focusing on these hard to reach patients with the Behavioral Health Integration Project – and is aiming to connect folks to primary care services right at their behavioral health clinic or site. For one consumer, this model was life-saving. As a 45 year old male who has struggled with schizophrenia for over 20 years, Joe had become comfortable with his counselor at his mental health clinic. He trusted her and felt that she would always be someone to assist him when in need. When he started experiencing shortness of breath while walking to his appointments each month, he shared that with his counselor. Since there was an integrated model in place, his counselor suggested he meet with the nurse practitioner located in the same building who could give him a quick exam. After being diagnosed with asthma, and working out a regimen with the nurse practitioner, Joe was feeling better in a matter of weeks. If this collaboration was not in place he would not have been treated for his health issue since he had issues trusting others and was unwilling to go for his annual physical exams.
Another example of successful integration is the flip model which includes housing behavioral health professionals or counselors within primary care offices. By utilizing screening tools for depression, anxiety, substance abuse and other issues, physicians are able to identify folks who may be in need of behavioral health interventions. Patients who are already connected to their primary care physicians are screened for depression, anxiety and other behavioral health issues at their annual visits. If screens indicate a potential need for behavioral health linkages, a behavioral health specialist is located within the same primary care office.
In one of our South Town locations, a young woman scored high on an anxiety screen when she visited for her first routine check-up. With some exploration by the behavioral health counselor (who was located up the hall), it was uncovered that she had experienced physical abuse as a youth and was uncomfortable with physical exams. Since the behavioral health specialist and physician work so closely in this integrated model, the woman was able to first address her behavioral health needs and then focus on her physical health needs once she felt safe and comfortable at the site. This approach to treating the whole person at one convenient location is one that needs to expand to ensure improved healthcare for consumers. For more information on behavioral integration models, visitwww.samhsa.org or www.millenniumcc.org