Though the brain and the body are closely connected, mental and primary healthcare has long been divided. Separating the two ultimately creates problems for both the patient and the provider. This, along with an existing stigma and shortage of providers, makes mental health care difficult to access–even for those actively seeking help.
In fact, Mental Health America states that over 50 million Americans experienced mental illness in 2019, and more than half of those adults (over 28 million) could not receive the treatment they desperately need.
Lack of access to care is the driving force behind these figures. Currently, there is an estimate of only one mental healthcare provider for every 350 individuals in the U.S. An AMA article also notes that in rural counties, 80% lack a single psychiatrist, leaving many individuals and families unable to reach mental health treatment.
This disparity can eventually result in worsening health outcomes. When left untreated, mental health issues can quickly deteriorate, leading to homelessness and even suicide.
This issue also contributes to high utilization and increased cost of care. Depression is a prime example, as medication costs anywhere from $233 to $1,992 for a 30-day supply without insurance. If left untreated, depression can lead to other mental health issues like substance use disorder, for which treatment costs a staggering average of $57,193 per patient.
On top of worsening health outcomes and high utilization, lack of access also creates more pressure on an already overburdened health system. According to results published in the Mayo Clinic Proceedings, burnout symptoms suffered among physicians have risen from 38.2% in 2020 to 62.8% in 2021.
Solving the Mental Health Crisis Through Integrated Care
Properly integrating primary and behavioral health care is at the root of solving this nationwide issue. In areas where behavioral health care is difficult to access or for organizations who serve individuals without the financial means to seek it, developing a process to identify and treat mental health in primary care can help address this growing problem.
Using a team-based approach gives primary health providers the tools to be proactive and prevent mental health crises by diagnosing and treating patients while receiving additional support from behavioral health specialists.
This means anyone with access to primary care would also gain access to behavioral health screenings and proactive support, allowing them to skip long wait times for therapists and eliminate concerns about insurance coverage.
The Common Wealth Fund noted in 2017 that the application of a team-based care model resulted in:
- 23% reduction in emergency room visits.
- 10.6% reduction in hospital admissions.
- 7% reduction in primary care encounters, easing the strain on the healthcare system and allowing patients to receive better, more attentive care.
Integrating care typically occurs gradually and can start with something as simple as assessing patients regularly for mental health needs. Different technologies, such as telemedicine or remote, digital assessments, can also be great tools to further advance care integration. To learn more about how technology can improve access to behavioral health care, check out our blog on digital mental health.
Better Patient Experience and Satisfaction
One of the primary reasons to integrate behavioral health care is because patients want a more holistic approach to care that incorporates mental health treatment. A poll conducted by Harris Insights & Analytics on behalf of Samueli Integrative Health Programs found that 72% of patients surveyed spoke about their physical health with their primary care physician, and only 36% discussed their mental health. Younger patients in particular (age 18-44) wanted their primary care physicians to ask them more about why they want to be healthy (55%) and share non-drug treatments (63%).
When patients do receive integrated care, their satisfaction with providers tends to be higher. In one study, patients were surveyed at an integrated care clinic and asked to rate on a scale of 1 to 5 how much they agreed with statement prompts. Patients reported high levels of satisfaction with their care and indicated that going to the integrated care clinic saved them money.
Improved Health Outcomes
Though the healthcare system has a long way to go towards full integration of care, we know from dozens of studies that the mind and body are strongly connected. According to the National Institute of Health, those with depression are at a higher risk for cardiovascular disease, diabetes, stroke, pain, Alzheimer’s disease, and osteoporosis. Similarly, the MHA reports that those with anxiety may be at a higher risk for skin diseases.
Because the mind and body are interconnected, integrated, measurement-based healthcare can improve overall health outcomes by catching and addressing these behavioral health issues before they cause more damage to the body.
An article posted by Common Wealth Fund states that when primary care providers worked together with behavioral health providers, patients experienced significant improvements in their depression and anxiety.
Another paper by the International Journal of Integrated Care found that using integrated care produced a positive impact on hospital admission rates, length of stay, readmission, and patient satisfaction. This is especially beneficial for providers who are making the shift to value-based care.
Lower Utilization & Cost Savings
Integrating mental health care in the primary care system is one of the best ways to lower utilization and cost. The CDC reports that emergency department visits lasting four hours or longer were higher among those with a mental illness than those deemed mentally healthy.
Another example of the effectiveness of integrated healthcare is a Rhode Island study posted by the National Institute of Health. They reported that emergency department visits were reduced by 7%, and office visits were reduced by 6%. Our own analysis with Jefferson Health found that integrated care decreased emergency department utilization by 34%.
This is because integrated care can deliver preventative care, meaning patients are less likely to visit an emergency room or be readmitted to a hospital due to their behavioral health condition. Lower utilization can lead to significant cost savings. A 2017 Milliman research report estimates that integrated care, when implemented across the entire health system, can save $67.8 billion in healthcare costs.
Improved Provider Satisfaction
One of the most significant benefits of mental health treatment in primary care is easing provider workload and stress. Providers face significant burnout, especially on the heels of the COVID-19 pandemic. Part of the problem is that patients with underlying mental health conditions aren’t given the proper tools and, thus, frequently utilize healthcare resources. Lessening these repeat visits and helping patients heal faster can lower providers’ workload in the long term and improve satisfaction overall.
When tested, one study posted by the NIH found that “providers exhibited a generally high degree of satisfaction with the integrated model.” This is due to patients receiving better care and providers being able to collaborate with more colleagues.
The NIH also notes that because of better patient outcomes, tension risks between patient and provider are lower, creating lower turnover rates, fewer clinical errors, and improving the work life of providers.
Overall the benefits of mental health integration span nearly every part of the healthcare system and create a path towards better results for both patients and providers. To learn more about integrated care, check out our article on behavioral health integration best practices.
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