Laura Galbreath, M.P.P., Director
SAMHSA-HRSA Center for Integrated Health Solutions, National Council for Behavioral Health
Walk into a community behavioral health or health center right now and you’ll probably see posters about this great new health care approach called integration. What is integration, though? And what does it look like?
As our health care system strives to improve patient health outcomes, improve the quality of care, and make care affordable, a collective light bulb has gone off. To achieve these three aims—known by the phrase “the triple aim”—we have to recognize and treat people’s physical and emotional health, and that means changing how we deliver care. Integration is one approach receiving a lot of attention for its promise to achieve these aims.
When my friends and family ask what integration is, I explain it like this: Integration improves access to mental health and addictions treatment by making that care a routine part of a visit to primary care, whether at the lowest level of integration (improved communication among providers) or the highest (a merged practice that includes both medical and mental health services). Integration also improves the quality of recovery by addressing the physical health care needs of people with mental illnesses and addictions.
How It Works
In practice, your primary care doctor may ask questions on your health history form to get a sense of your emotional state and use of substances like alcohol and tobacco.
In the exam room, the medical team may ask additional questions to assess whether you could benefit from speaking with a mental health professional or from treatment for any untreated mental health conditions.
Even if you do not have a diagnosed mental illness or addiction, your primary care doctor may invite a behavioral health professional into the exam room to help you identify strategies to support your health goals, like remembering to take your medication on time, reducing your salt intake, etc.
Your primary care doctor may take on an increased role in coordinating your care with your other providers, like your counselor or case manager, and making sure that all your providers are clear about the medications you take.
Such care coordination is just as important to your mental health provider. A member of the mental health team will also likely help coordinate your care among all your different providers, help you understand any physical health conditions you may have, like diabetes, and teach you strategies to manage your conditions.
You may wonder what’s so new about this. Perhaps you thought this was already the norm.
Unfortunately, this coordination hasn’t been implemented by or required consistently from providers. It’s a simple concept, but there is a lot involved. Integration changes the way health care is delivered and requires quality care, adequate funding, technology to share information, and identifying the best health professional to coordinate a person’s care.
However, given what we know about how much more prevalent chronic health conditions like heart disease, diabetes, obesity, and tobacco dependence are among people with mental illnesses and addictions, it is heartening to know that our health care system is finally working toward reconnecting the mind and the body.
How can you ensure that you are receiving the best and the most coordinated care?
Next time you go to your mental health provider or primary care office, ask how they are coordinating your care with your other providers. It’s the first step in making sure you receive the most out of your health care.
If you’re confused about all these different terms in health care reform, you’re not alone! Here’s a glossary about integration and some other resources:
Share your thoughts and experiences!
What are some examples of how your physical health impacts your recovery goals?
Would having primary care services located where you receive mental health or addiction treatment make you more likely to get a check-up?
When trying to manage the information coming from different medical and behavioral health providers, what is the toughest part?