If you’ve spent any time in the world of health care recently, even if it’s just been on the edges, figuring out what ObamaCare (also known as the Affordable Care Act) means for your budget and your access to health care, you’ve most likely heard talk about the integration of care. The reference these days is to the integration of your primary medical care with your behavioral health care. Behavioral health care is a relatively new term that refers to the services that address your mental, emotional and behavioral health.
We have come to realize that the similarities between what we used to think of as two separate and distinct areas of health, physical and mental, are much greater than the differences.
They are intertwined; the mechanisms that operate in each use similar processes, chemicals, and pathways; and our physical health affects our mental health and our mental health affects our physical health. If we are going to work to promote good health, we must pay attention to both the physical and the mental/emotional.
Integrating mental health and primary physical health aims to expand the provision and availability of mental health care, a traditionally underfunded and neglected area of health care. Integration will also improve prevention efforts and remove barriers to treatment, especially by erasing the stigma usually associated with seeking mental health care.
Here are statistics from the National Alliance on Mental Illness, also known as NAMI, that point to the long-standing lack of access to needed mental health services experienced by millions of children.
w Almost 20 percent of children in the United States experience some form of a mental illness and only 20 percent of those children receive any kind of treatment.
w Thirteen percent (13 percent) of youth ages 8 to 15 live with a mental illness severe enough to cause significant impairment in their day-to-day lives and this figure jumps to 21 percent for teenage youth ages 13 to 18.
w Half of all lifetime mental illnesses begin by age 14, three-quarters by 25
w Five percent (5 percent) of children and adolescents suffer from complex illnesses requiring long-term treatment.
w The average delay between onset of symptoms and biopsychosocial intervention for children is between 8 and 10 years – critical developmental years in the life of a child.
Coordinated psychiatric treatment in a primary care setting has been shown to significantly optimize care by providing early identification and intervention. This leads to early access to care, reduces hospitalizations and emergency room visits, and improves treatment outcomes. Psychiatric evaluations include assessing a child’s or adolescent’s symptom or behavior from a biological, psychological, social, and cultural perspective.
Understanding the child’s environment, family, and strengths also serves a critical role in accurate assessment and treatment. Treatment may include individual and/or family therapy, medications, consultation, and coordination with physicians, other health care providers, therapists, schools, juvenile courts, social agencies, and other community organizations.
The advantages to our community and society as a whole are immeasurable. As the health of our community improves, so do the other measures of our community well-being, social, financial, familial, and organizational. And it all starts with the integration of our body and our mind.
Kathy Sheffield will be honored on Oahu later this month for her pioneering work in bringing understanding of the great importance of mental health to the health of the individual, the family, and the community. She is the founder of the Kauai affiliate of NAMI (National Alliance on Mental Illness) and provides education and support to families with loved ones who suffer from mental illness.
Chia Granda, M.D., and Madeleine Hiraga-Nuccio, LCSW, of the Kauai Family Guidance Center, part of the Child and Adolescent Mental Health Division of the state Department of Health.