NPR reports that the Oregon-area St. Charles Health System is experimenting with its model by bringing together a variety of medical professionals, including primary care doctors and behavioral health therapists, into a single setting. That’s intended to help the patients who need to be treated for both physical and mental health problems, but may be reluctant or unable to follow up a doctor’s visit with a trip to a referred psychologist. And as millions of Americans gain coverage under Obamacare, this tactic could become more widely-used.
Pursuing mental health care is often a burden for those who need it. While close to 20 percent of the U.S. population has a mental health disorder, just over 38 percent of those Americans actually pursue care. According to Substance Abuse and Mental Health Services Administration (SAMHSA), there’s a variety of reasons for that:
CREDIT: SAMHSA/2011 Survey On Drug Use And Mental Health
About 15 percent of Americans with mental illness blame a lack of insurance coverage for forgoing care. That will soon change. Thanks to the Affordable Care Act’s designation of mental health care as an “essential health benefit” that insurers have to offer, approximately 32 million Americans will gain mental health coverage through their individual or small group plans beginning in 2014 under Obamacare. Another 30 million will get more robust benefits than they have today, since insurers will be forced to cover behavioral disorders the same way they cover more “traditional” medical care.
But Americans need to actually go out and visit mental health professionals in order to take advantage of that new coverage — and there are still barriers keeping them from doing that. Thirty five percent of people with mental illnesses say they avoid treatment due to its associated stigma. On top of that, there’s a shortage of readily-available mental health providers. That’s where experimental models such as St. Charles’ come in.
For instance, NPR highlights the story of 17-year-old Tyson Engel, who suffered a major head injury that altered his behavior. After failing to get help at various emergency rooms, Tyson’s parents eventually brought him to a St. Charles facility, where he was treated by both a pediatrician and a clinical psychologist. In tandem, they were able to address his physical injuries while teaching him coping mechanisms to deal with the behavioral effects of his head trauma.
Proponents of that kind of integrated care from other states say this model is critical to removing the stigma of mental health care and make a patient’s long-term recovery far more likely. “If a patient gets comfortable with a counselor before ever leaving the building, he’s much more likely to return,” 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.
The data suggests that the coordinated care approach also reduces health care costs, since patients are less likely to suffer from an accident or physical health problem caused by an untreated underlying mental health issue. In fact, St. Charles’ pilot program is already reaping benefits — its annual care costs for Medicaid patients have fallen by about $860 per patient despite a small increase in pharmacy costs.