Integrated Care Track Presents Thorough Overview

APA President John Oldham, M.D., has chosen “Integrated Care” as the theme of his presidential year and this year’s annual meeting, so it’s not surprising that the meeting includes a special track of sessions featuring the most comprehensive array of presentations ever offered on the topic at the meeting. The sessions will be led by top experts in the field, including Wayne Katon, M.D., Benjamin Druss, M.D., Jurgen Unutzer, M.D., Roger Kathol, M.D., Joseph Parks, M.D., Benjamin Miller, Ph.D., and Frank deGruy, M.D.

Integrated care is a range of collaborative efforts with our primary care colleagues in diverse settings to improve patients’ overall health. These efforts run the spectrum from utilizing our expertise in primary care settings to help with the detection and treatment of mental illness to engaging primary care professionals to help with the treatment of patients with medical problems in our mental health settings. The outcome of these partnerships can result in “improved lives and lifespans,” as stated by Steven Sharfstein, M.D., CEO of the Sheppard Pratt Health System, in a recent editorial in the American Journal of Psychiatry. In addition, an emerging database shows cost savings in the overall health care system when integrated models of care are implemented.

Integrated care is different from standard consultation in that it encompasses several “core principles” recently established by the Advancing Integrated Mental Health Solutions (AIMS) center at the University of Washington in Seattle. Unutzer is director of AIMS and principal investigator of the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) studies. He led a summit in May 2011 that resulted in a well thought out inventory of essential values prominent in integration efforts.

The core principles of effective integrated care include person-centered-care teams providing evidence-based treatment to a defined population of patients using a measurement-based “treat to target” approach. This system of team-based care also provides a way to extend limited psychiatric expertise across larger groups, providing one promising solution for areas in which there is a shortage of psychiatrists. Integrated care provides a framework for thinking about our role in communities as we position ourselves for health care reform and market our value in evolving systems of care.

Integrated care has a robust evidence base consisting of more than a decade of studies from multiple settings across the country. From the pioneering work of Katon over a 30-year career, the repeated success of IMPACT trials extended to other populations, the success of Druss in showing improved health status of people with mental illness in public settings, and more, integrated care has demonstrated proven, effective models with psychiatrists prominently featured as essential to the efficacy. However, psychiatrists in many clinical settings have not had the training opportunities until now to join this health care revolution in well-informed and meaningful ways. This year’s annual meeting in Philadelphia will provide a much-needed opportunity to discover and learn more about this evolving subspecialty area.

One of the highlights is the first course on integrated care ever offered at the annual meeting—Course 4, “The Integration of Primary Care and Behavioral Health: Practical Skills for the Consulting Psychiatrist.” It will be held on Saturday, May 5. On Sunday, May 6, top experts in the field will come together to share ideas and encourage dialogue with attendees in Forum 3, “The Future is Now: The Evolving Role of Psychiatry in the Integration of Primary Care and Behavioral Health.”

The presidential symposium “New Approaches to Integration of Mental Health and Medical Services” will be held on Monday, May 7. Also that day is Seminar 15, “Integrating Mental Health Services Within a Primary Care Setting: Effective Strategies and Practical Tips,” with Benjamin Miller, Ph.D., president of the Collaborative Health Foundation.

On Tuesday, May 8, the American Association of Directors of Psychiatric Residency Training will hold “Integrated Care and the Future of Psychiatry: Teaching Psychiatry Residents and Fellows to Work at the Interface of Mental Health and Primary Care” (Symposium 89). The track wraps up on Wednesday, May 9, with Workshop 133, “Roles for Psychiatrists in Integrated Care” sponsored by the American Association of Community Psychiatrists. Presenters will highlight key points from the chapter on integrated care in the soon-to-be-released Textbook of Community Psychiatry.

A complete list of the sessions in the Integrated Care Track is posted at http://psychnews.psychiatryonline.org/newsArticle.aspx?articleid=663885. Information also will be available on site in the Daily Bulletin and in a comprehensive handout.  

Lori Raney, M.D., is chair of APA’s Work Group on Integrated Care and can be reached at [email protected].