Peter Ashenden
Tuesday, October 07, 2008
For a long time, we’ve been saying that “there can be no health without mental health.” In fact, the IOM (Institute of Medicine) report Crossing the Health Quality Chasm makes an impeccable case for this statement. Since the IOM is arguably the most prestigious entity in health care, many of us thought this was a big step forward. (For more info on the IOM’s report on mental health and substance use specifically, visit Improving the Quality of Health Care for Mental and Substance-Use Conditions.)
The value of integrating mental health into overall health was driven home even more by the late 2006 report from the National Association of State Mental Health Program Directors (NASMHPD). This document revealed that mental health consumers are dying 25 years earlier than the general population, in part, because we don’t see out primary care physicians.
More support of this idea of “whole health” stemmed from the report by the Annapolis Coalition. This report outlined the trouble with the mental health workforce, including the aging of the workforce, the lack of new hires and the shortage we currently have and can expect to see in the future.
What do I mean by “whole health” and integration of health and mental heath? Well, a lot of things. Wouldn’t it be nice, for example, if my mental health professional talked with my primary care doctor and vice versa? It would be smart for them both to know what I’m being treated for, so that medications are prescribed appropriately … and so they can work with each other and work effectively. For example, there are certain psychiatric meds I shouldn’t take if I live with diabetes or kidney disease.
It would be nice if treatment plans were in synch. Say my primary care doctor is working on a weight loss plan. Well, it’d be helpful if my psychiatrist used that in creating my treatment plan with me.
And it might be helpful if my health care records were integrated, so that, if an emergency occurred, everyone would know the full extent of my treatment, as well as information on all of my doctors, in case one isn’t available. Some groups are advocating for a medical “home,” one place where all records are stored so we don’t spend all our time wandering from doctor to clinic to nurse to social worker saying the same thing over and over again, trying to make our health system work for us instead of against us.
But at the core, this integration or “whole health” means that I’m seen as a whole person … that my body does not stop at my neck … and that working on my health—my mental health—is part of the big picture.
It’s a vision of the future that a lot of people are working to make a reality. One of the places making great strides toward this is the Collaborative Family Healthcare Association (CFHA). The CFHA promotes a comprehensive and cost-effective model of health care delivery that integrates mind and body, individual and family, patients, providers and communities. So, if this vision of an integrated health care system speaks to you, you might want to check out this organization.
