Medical schools, hospitals and national organizations have launched initiatives and programs to better incorporate mental health services into primary care.
Here are five mental health industry experts' thoughts on the push to destigmatize and increase access to mental health treatment through the integration of behavioral health services and providers into primary care settings:
Note: Responses have been slightly edited for length and clarity.
Terri Coyle. Vice President of Behavioral Health at St. John’s Episcopal Hospital (New York City): The past few years have delivered a surge in child/adolescent behavioral health needs, and we want to ensure that we are meeting those needs as well as providing preventive services. Our Community Mental Health Center is being relocated to a bigger, more modern space that will allow us to offer family peer support services, care coordination, psychiatric and psychological assessments and individual and family counseling all in one location to ensure that families receive the wrap-around support they may need.
We are also focused on prevention through identification and intervention of children in our pediatric practices that may be at risk. We currently embed clinicians in the pediatric primary care practices as part of our adoption of collaborative care model but in 2023, EHS will pursue grant funding for a Healthy Steps program, which is a nationwide, evidenced-based model that provides early childhood development support to families where they are most likely to access it: the pediatric primary care office. With these initiatives, the CPEP and the expansion of child and adolescent services, EHS is committed to responding to both those in our community who are suffering and in crisis and also investing in the structures and programs that contribute to the strength and resilience of the families of the Rockaways.
Sheryl Kingsberg, PhD. Chief of the Division of Behavioral Medicine Department of OB-GYN at University Hospitals Cleveland Medical Center: [A big issue is] identifying mental health conditions in primary care and providing access to services early to address patient needs and avoid having these psychiatric conditions surfacing in EDs, or at a crisis point and causing unnecessary pain and costs. [This allows for] early [diagnosis] and provid[es] multiple modalities to patients' for access to mental health services, i.e. "access healthcare your way."
Ahsan Mahmood, MD. Chief Medical Officer, Parkview Health (Fort Wayne, Ind.): My excitement for the future is mixing behavioral healthcare into primary care, just like we mix sugar into coffee. Collaborative models of care bring behavioral healthcare into primary care services. It's also exciting to see new therapies for treatment-resistant depression emerge and become more available to the public. The addition of mental health resilience education to early-childhood school programs is exciting and much needed.
Erika Saunders, MD. Penn State College of Medicine Psychiatry Department Chair, President of the American Association of Chairs of Departments of Psychiatry: Our focus is on access to services. We are working on [providing] easier access to services across a continuum of care [by] rolling out consultation methods like e-consult and tele-education models, in which specialists and primary care providers discuss treatment based on cases and developing services integrated in primary care and expanding telehealth. [This] successfully treat[s] most patients quickly in primary care … which then opens access to specialty care for more difficult-to-treat illnesses. Additionally, we are working to ensure higher levels of care such as partial hospital programs and inpatient programs are as accessible from the emergency department as soon as possible, so patients can get into the right treatment setting.
Michelle Schafer. Regional Vice President and System Clinical Program Chair of Behavioral Health, SSM Health (St. Louis): Addressing the behavioral health needs of the communities we serve is part of our system strategy focus over the next several years. [W]e want to be able to identify the behavioral health needs of our patients as early as possible [by integrating mental health services at] a majority of our primary care physician offices by the end of 2024.