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How Doctors Are Preparing For The Millions Of People Who Will Get Mental Health Care Under Obamacare

By Sy Mukherjee

"How Doctors Are Preparing For The Millions Of People Who Will Get Mental Health Care Under Obamacare"

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Approximately 62 million Americans will gain access to expanded mental health care services under health care reform, according to estimates by the Department of Health and Human Services (HHS). But as the Wall Street Journal reports, there may not currently be enough mental health professionals to meet that increased patient demand — and that’s why primary care doctors and psychiatrists are teaming up to prepare for a growing number of insured Americans who may seek mental health services.

Recent legislation ensures that millions of Americans will either gain mental health coverage for the first time or have access to an expanded list of services in the coming years. That’s because Obamacare requires individual and small group plans to provide mental health benefits if they don’t already do so beginning in 2014 — a provision that is estimated to help over 32 million Americans have access to mental health care next year. The Affordable Care Act also expands on a 2008 law that requires insurers to offer the same level of mental health care services as they do for traditional medical care, which will give an additional 30 million Americans who have skimpy mental health benefits a more robust set of options to choose from.

Unfortunately, mental health professionals aren’t always so easy to come by, particularly for poor, isolated, and vulnerable Americans. For instance, over 85 percent of the areas that the federal government deems as “mental health professional shortage areas” are in rural communities. “[O]nly in rural America did the National Advisory Committee on Rural Health find entire counties with no practicing psychiatrists, psychologists, or social workers,” according to a 2009 report by the Center for Rural Affairs.

For these Americans, primary care doctors can serve as a crucial resource for mental health care. As the Journal reports, integrated medical systems where primary care doctors do the initial legwork in identifying patients who may have mental disorders and then refer them to counselors and psychiatrists are growing in popularity. Such a system may involve the primary care doctor prescribing medications such as anti-depressants and then having his or her patient be monitored by a clinical social worker, or simply referring the patient to a counselor on-site in the hospital. That tack can encourage more Americans to follow up on their mental health needs since it allows them to immediately interact with a mental health care professional instead of having to take it upon themselves to seek out a referred psychiatrist.

“It’s so important to capture that moment,” said internist Thomas Goforth, medical director of the Family Health Center of Harlem — an integrated-care center in New York City — in an interview with the Wall Street Journal. “If a patient gets comfortable with a counselor before ever leaving the building, he’s much more likely to return.”

Public health organizations have been pushing primary care doctors to get more involved in mental health care. In June, the Robert Wood Johnson Foundation (RWJF) and General Electric’s philanthropic arm teamed up to sponsor an experimental program known as Project ECHO with a New Mexico facility that allows mental health specialists to teach social workers, nurses, and primary care doctors about the basics of mental health care through weekly Internet teleconferences.

“This approach with Project ECHO will bring mental health care to patients in their home communities with local clinicians,” said Bob Corcoran, president and chairman of the GE Foundation, in a press release. “We think this will not only improve access to mental health care, but ultimately improve overall well-being and quality of life for these patients and their families.”

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