Opinion: Health care integration = WHOLE health care

By Donald J. Mares

It is no secret that there is a strong connection between the mind and body. Religious leaders, philosophers, doctors and many others have discussed the mind/body connection for centuries. Yet the treatment of mental and physical health has been compartmentalized in modern Western medicine. In the United States, there are two systems of care: the behavioral health system and the physical health system.

These systems are perpetuated through insurance reimbursements, through laws, medical education and many other cultural and social institutions. The distinction between mental and physical health is both a product and promoter of the stigma associated with mental health. This distinction also creates many barriers to accessing high quality mental health care in the United States.

One of the most productive ways of closing the treatment gap for untreated mental illness is incorporating mental health treatment options with physical health care though an integrated model of service. The primary care level of service is one of the most logical areas to establish an integrated care framework. Primary care, as defined by the American Academy of Family Physicians, is care received at a patients initial contact with the health care system.

Primary care providers play an important role in identifying and treating mental health disorders. About 75 percent of all primary care visits involve a mental health component. Over 40 percent of people with depression and/or anxiety are first diagnosed by their primary care providers and over 20 percent of undiagnosed adults indicate that they would first see their primary care provider for help with a mental health issue.

Although primary care providers treat a large portion of mental health issues, they currently face many challenges in treating them, including insufficient insurance reimbursements, a high demand for care and a lack of specialty training. These challenges will increase as more individuals gain access through the National Patient Protection and Affordability Act.

There are models of successful integration: Some college campuses have integrated their student health care systems to include physical and mental treatment in one location with success. Community health centers and health maintenance organizations are also providing integrated care at many locations.

Mental Health America of Colorado has promoted integration through our programs and public policy work for several years. For example, MHAC helped create and advocated for the passage of Senate Bill 07-36, which requires companies employing 50 or more employees to offer mental health insurance coverage that is equal to physical health insurance coverage (commonly known as parity legislation). Gov. Bill Ritter signed the bill into law in 2007.

MHAC is committed to the principle that mental health is an essential part of every persons whole health and well-being. Every Coloradan should receive mental health and substance abuse prevention, treatment and long-term support regardless of how they enter the health care system.

Treating the whole person through the integration of mental and general health care will save lives, reduce negative health outcomes, facilitate quality care and result in long-term cost savings.

About the writer: Donald J. Mares is the President and CEO of Mental Health America of Colorado, a non-profit organization providing 58 years of leadership to address the full range of mental health and wellness issues in Colorado.

Opinions communicated in Solutions represent the view of individual authors, and may not reflect the position of the University of Colorado Denver or the University of Colorado system.