Integrated Approaches Improve Care, Lower Costs

100614692Fifty years ago, the president of the American Pediatric Society dreamed of employing psychologists in pediatric centers. Today, that dream of integrating physical and mental health care is a reality, thanks in part to 2008’s Mental Health Parity Act and the 2010 Affordable Care Act, said presenters at an APA convention symposium on innovative care strategies for youth.

Research shows integrated care not only reduces health-care costs, but benefits families and children, said Joan Asarnow, PhD, of the University of California, Los Angeles, Geffen School of Medicine, who conducted a meta-analysis looking at integrated care.

“When we go in and provide integrated care, our kids are more likely to get better,” she said.

But challenges remain. For one, mental health parity is not always well enforced and only 4 percent of Americans know that health insurers are required to provide comparable coverage for mental and physical health care, according to an APA survey.

Further, disparities persist in mental health care: Minorities with mental health disorders are much less likely to receive mental health care — and appropriate care — than white populations, said Jeanne Miranda, PhD, of the University of California, Los Angeles. Minorities are also vastly underrepresented in the mental health care workforce.

To overcome such barriers and better integrated mental and physical health care, speaker Marc C. Atkins, PhD, of the University of Illinois at Chicago, called for expanding the mental health workforce, realigning mental health resources and developing a natural extension from prevention to intervention.

Tailoring interventions on a smaller scale is important, too, said W. Douglas Tynan, PhD, director of integrated care at APA who offered suggestions for those looking to integrate mental health care into existing primary-care clinics. “After you find out [the clinic’s] greatest need, develop a protocol and then develop a practice team,” he said.

Sharon G. Portwood, JD, PhD, of the University of North Carolina at Charlotte, said keeping prevention and wellness “at the forefront” of efforts is also key.

Psychologists have a key role to play in all of this work since many are experts in interventions that improve health outcomes, such as motivational interviewing, self-management training and problem-solving, said Terry Stancin, PhD, of MetroHealth Medical Center. “There’s a very important role we have to play in integrated-care settings,” she said.

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