Treatment of the human mind separately from the body’s other components is hardly a new practice. The mind has been viewed as being essentially different from the body since the days of Aristotle; but the 17thcentury philosopher Descartes is credited as first formulating the mind and body duality. Around the turn of the twentieth century, that perspective was incorporated into the new field of psychiatry, and the same basic view persists today. Now one might ask, how is this relevant to anything of importance today? Well, national healthcare reform seems to be on everyone’s mind these days, for many different reasons. As consumers, a lot of us are struggling with the incessantly escalating costs of health insurance premiums, the increasing out-of-pocket expenses (co-pays, deductibles, etc.) and the limitations of coverage offered by health plans. After providing health coverage for their employees for years, many employers are finding the rising premium costs to be prohibitive, resulting in companies having to drop health plans entirely as a benefit. Even the President and Congress have taken notice of the problem, prompting an intense national debate on the subject.
In our little corner of the universe— community mental health—there is an issue in the healthcare reform conversation that might cause Descartes to roll over in his grave: the “integration” of community health and community mental health care. Simply put, this refers to the potential melding of the two related systems of care for people who have few financial resources. Typically, the clients in these systems either have inadequate health insurance or none at all. If they do have coverage, it is often a federally subsidized plan, e.g. Medicare or Medicaid. If they do not have coverage, they tend to use hospital emergency room services whenever they need help.
Neither the community health nor the mental health system is well-funded, which is why the issue of integration of the two systems is such a hot topic these days. It also is the reason that some primary care and mental health providers are starting to warm up to each other.
Of course, from the patient perspective, there is an excellent reason for primary care and mental health providers to collaborate: it promotes good overall health care. The clear fact is, Mr. Descartes was wrong. The human mind and body are inextricably linked together. Not only does it make little sense to ignore one major facet of the body while treating the other; to do so often can place the patient at risk. The interaction of different medications can have negative consequences both for one’s medical functioning and psychiatric condition.
In an ideal health care system, a patient should have one person who is responsible for monitoring all medical (and psychiatric) conditions for which the individual is being treated. This model is even more important if the patient drinks or uses drugs, since these will impact the effects of any medications that the individual uses.
Close communication and coordination of treatment decisions and activities between one’s primary care and mental health providers would likely reduce the number and degree of negative consequences for the patient, improve his/her health outcomes, and in the process, probably save taxpayers a great deal of money.
With these and other goals in mind, Sound Mental Health has engaged in partnerships with primary care providers for many years. We plan to strengthen and expand such relationships in the future. We understand that physical and mental health go hand in hand and it is an essential part of our purpose to promote both for those we serve. In that way, we can improve not just the quality of life for our clients, but for the larger community as well.
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