The Scientific Program Commitee of the Institute on Psychiatric Services has ensured that integrated care topics have a prominent place on this year’s program.
Integration of general medical and mental health has been an issue for discussion since the 1960s, when psychiatrists in England started to spend more time addressing physical complaints associated with comorbid depression and anxiety. Initially, it was thought that general practitioners could treat these conditions, but further surveys showed that the problem needed a more comprehensive approach by psychiatrists and mental health professionals due to the complexity of the comorbid physical and mental illnesses.
Studies have shown that more than 95 percent of patients with mental illness are treated in community clinics, with anxiety and depression accounting for the vast majority of these conditions. Government policies around the world have embraced providing mental health services in local community clinics, with the vision of improving quality of care and providing a cost-effective service.
Tony Kendrick and colleagues performed a formative research study in which 90 percent of primary care providers said they would treat individuals with mental illness if they had the support or available consultation from a psychiatrist, psychiatric nurse, or psychologist to discuss treatment options, referrals, and psychosocial interventions. But this arrangement has not occurred most of the time, with primary care providers expressing frustration when caring for people with mental illness due to lack of communication with mental health care providers, lack of resources outside the community clinic, and poor response to treatment needs by local governments. These concerns have contributed to a crisis that requires changes in health policy and leadership.
Since the introduction of the 2008 federal parity law, which mandates equal benefits for Americans whether they suffer from mental or physical illness, and now with the Affordable Care Act, the health care system has been facing the new challenge of integrating not only mental health needs but the growing chronic physical health problems that Americans face and that are likely to become more prevalent as the population ages.
The California Psychiatric Association, in association with APA, has voiced the need for legislators to make integrated care a priority to improve and promote treatment of mental illness within primary care services.
APA’s 2014 Institute on Psychiatric Services—to be held October 30 to November 2 in San Francisco—will have several interesting and informative lectures and other sessions that will address the growing interest in integrated care. We are fortunate to have this meeting here in California, where the idea of integrated care has been in the works for quite some time.
There is a consistent body of evidence in the literature that addresses the effectiveness, efficiency, and continuing need to integrate mental and physical health. We are confident that attendees at this year’s institute will find that this meeting will go a long way toward fulfilling the needs of those who dedicate their practice to treating individuals attending our community health clinics. It is clear that community clinics will continue to provide the vast majority of health care and prevention in the United States. ■
Alvaro Camacho, M.D., is an assistant clinical professor of psychiatry at the University of California, San Diego, director of the Sun Valley Research Center, and a member of the Scientific Program Committee for the Institute on Psychiatric Services.
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