As a nation, we’ve made strides in recognizing the importance of diagnosing and treating people who have mental health and/or substance abuse concerns, but we still have a long way to go. Health care reform gave more Americans access to health coverage and treatment, but 56% of the roughly 40 million adults with a mental illness in 2018 still did not receive treatment, notes Mental Health America in its report, The State of Mental Health in America in 2018.
But that’s only part of the story — 68% of adults with a mental illness also have one or more chronic physical conditions, such as high blood pressure, heart disease, diabetes, obesity, asthma, and smoking, according to the SAMHSA-HRSA Center for Integrated Solutions.
It’s easy to fall through the cracks
In a health system that often leaves individuals responsible for coordinating and managing their own care, it is easy for people with mental health concerns to fall through the cracks. When — and if — they finally get the care they need, their health conditions often are acute and require more intensive treatments. The best way of addressing this challenge, says the Center for Integrated Solutions, is by getting doctors in key medical disciplines to work together.
“The solution lies in integrated care — the coordination of mental health, substance abuse, and primary care services,” says the Center for Integrated Solutions. “Integrated care produces the best outcomes and is the most effective approach to caring for people with complex health care needs.”
Linking primary care and behavioral health services
Kaiser Permanente Colorado has practiced integrated care since the day we opened our first medical office 50 years ago, and that includes our mental health and wellness services. We have behavioral health providers at 25 of our medical offices, which also offer primary care services, and many of them are available for same-day, targeted psychiatric interventions. We designate a “doctor of the day” who helps coordinate care for members who have critical psychiatric needs. Any Kaiser Permanente Colorado physician can contact this doctor for assistance via our “Mind Line” phone, helping ensure that the member’s needs are met. Often, while in the midst of a routine visit, a primary care doctor can pull a behavioral health specialist into the visit to address mental health concerns with a member right on the spot.
Getting all doctors involved
The connectedness of Kaiser Permanente doctors extends beyond primary care and behavioral health, though. All of our providers — from pediatricians and pulmonologists to oncologists and orthopedists — are connected by a single electronic health record system. The system automatically reminds them when a member is due for a depression screening — one of many routine screenings we provide that cover the spectrum of potential health issues. This led to more than 50,000 depression screens being conducted in 2018 by doctors who specialize in disciplines other than primary care or behavioral health. In cases where depression was identified, these specialists worked with behavioral health providers to help the member get the services they needed.
The expertise of our physicians, and the way they work together, helped Kaiser Permanente Colorado earn recognition from the National Committee for Quality Assurance (NCQA) as the best provider in Colorado (or tied for the best) in 2018–2019 for:
- Mental and behavioral health overall
- Follow-up after hospitalization for mental illness
- Six-month adherence to medication for depression
- Engagement for alcohol/drug abuse or dependence treatment
Another aspect to helping people get the mental health services they need is ending the stigma that surrounds it. This stigma often renders people silent when it comes to seeking care for themselves or talking to a friend or loved one who might need help. Kaiser Permanente wants to create a culture of acceptance and support, which is why we created the Find Your Words campaign. The Find Your Words website offers free tools, resources, and information to help start a conversation about depression and find needed support.
No none should fall through the cracks when it comes to getting the health care services they need. Team-based care can help make that less likely to happen.