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In the US, millions of people live with both a physical and a behavioral health condition. Yet, our healthcare system frequently separates physical health care from mental health and substance use treatment. As a result, people are left with a divided health system that is difficult to navigate, leading to poor health outcomes.
People with serious mental illness often die 25 years earlier than the general population. Evidence suggests this is due to a combination of clinical risk, socioeconomic and health system factors plus a lack of integration when care is required across service settings.
Increasing the connections between physical and behavioral health – a model known as integrated care – has the potential to address the physical needs of people with mental illness across service settings to help improve treatment outcomes and overall well-being.
Integrated care at WellPower
Integrated care is a foundational principle at WellPower; everyone on our treatment teams sees themselves as an integrated care manager. By bringing our treatment teams – made up of psychiatrists, nurses, therapists, and case managers – together, integrated care can ensure that all health needs are being addressed concurrently, leading to better treatment and well-being.
“The people that are impacted the most by their mental health symptoms – those early in their recovery – often can benefit the most from integrated care services,” said Steve Fisher, LPC, director of clinical services. “They are so impacted by their mental illness that many of their other priorities fall by the wayside – and as a consequence, their overall physical health is frequently neglected.”
Everyone we serve has a treatment plan that is supported by the whole treatment team. Many plans include engagement with a primary care physician to help address physical conditions, which we are often able to provide through our primary care team onsite.
“Many of the people we serve are predisposed to not engage in the larger health care system in a proactive and productive manner,” said Fisher. “They are often reactive in nature – they tend to get physically sick and only then seek treatment.
Care coordination
One of the most important aspects of integrated care is the coordination of different components of a person’s treatment, both internally and externally.
Internally, our treatment teams communicate by phone, chat, email and through health information systems software to coordinate high quality care for the people we serve. Each treatment team meets weekly to discuss the people who are going to be seen by that team’s psychiatrist – this way the psychiatrist knows the topics of concern to address.
External communication is also important for facilitating engagement with the larger health system, which can present substantial barriers to those who don’t have the resources or knowledge to navigate it. Our integrated care teams help people find their way through the system in many ways, including case managers attending appointments with people we serve to take notes and ensure any follow-up exams, tests or x-rays are scheduled. When the people we serve need a type of physical health care service that isn’t offered at WellPower, we connect with other providers across the healthcare system to ensure all of the person’s needs are met.
“Our healthcare system is based on a certain set of values that a lot of people don’t prioritize – to exercise, eat nutritious food and schedule preventive appointments” commented Fisher. “We believe these things are incredibly valuable because they contribute to your overall well-being and add longevity to your life.”
Facilitating a positive healthcare experience
Shared decision making and patient activation are at the core of the integrated care management model. When the values, beliefs and goals of the person served are part of the process (shared decision making), the likelihood of their health behavior changing goes up (patient activation).
To further inspire the patient activation, the provider must engage the person’s motivation instead of telling them what to do – this is an art which many primary care providers are not well versed in doing.
“’Doctor’s orders’ used to be influential but there is a portion of the population for whom ‘doctor’s orders’ do not hold a lot of weight,” remarked Fisher. “I can’t ‘will’ someone well; I have to help them tap into their motivation and see what they are willing to do. If you can help individuals tap into their motivation, you may be able to help them avoid some of the more serious physical health conditions and instead experience physical and mental well-being.”
Integrated care not only helps individuals susceptible to not engaging in the overall health care system, but it also helps the overall health care system by improving the health of the population, enhancing the patient experience of care, reducing the cost of care, improving the well-being of practitioners and promoting health equity.
In our larger healthcare system, integrated care is still the exception rather than the norm, despite many advocates and other stakeholders pushing for it as the most effective way to help bridge gaps. While we work for the day that integrated care becomes standard practice across all of healthcare, WellPower will continue providing industry-leading integrated care to help the people we serve improve their well-being.