When we are stressed, our bodies feel it. When we are sick, our minds feel it. The idea that physical, social and emotional health are connected is the driving force behind integrated care.
While not yet the norm, integrated care has been building steam in the U.S. over the past 50 years and is the future of healthcare delivery. To get out ahead of the curve, The Village partnered with Connecticut Children’s Medical Center this year to transform two pediatric practices to provide integrated physical and mental health services, made possible by a grant from United Health Foundation.
“Families typically come in to see us with an ‘issue of the day’, but that is just a small piece of the overall health of a child,” said Dr. Cathy Wiley, a pediatrician who directs the integrated practices.
From the outside, it may seem as simple as placing a psychologist within a pediatric practice. This alone has benefits.
“We know that about 70 percent of visits to the doctor involve some behavioral health component,” said Dr. Lisa Backus, a Village health psychologist who works with Dr. Wiley and her team. “Yet, if a pediatrician refers a patient to a mental health provider in the community, only about 15 percent of parents will follow through and make the appointment for their child.”
“Before, we would typically provide parents with a list of mental health providers accepted by their insurance,” said Dr. Wiley. “Now, we can introduce them to a colleague – a member of our team – who can help them right here. That has an immediate and positive impact on the family’s level of trust.”
Blanca, whose 14-year-old son has been a patient of the practice since he was born, appreciates the additional services now available to her family.
“Dr. Backus was there for us at the right time,” said Blanca. “We were going through some things as a family, and my son needed help working through it all. If we had received a list of providers, it’s something we could have just left for later. Instead, we were able to meet Dr. Backus and make an appointment right away.”
The integrated pediatric practices go even further down the path of supporting a child’s health − and their family’s health – by providing access to basic human needs and community resources.
“If finding transportation to your child’s appointments is a challenge, I can help with that. If you’re having trouble getting your child academic support or finding family activities in the community, I can connect you to resources,” said Veronica Flores, one of two Village care coordinators stationed at the pediatric practices. Veronica helps families identify and access resources in the community that help with anything that might impede a family’s ability to thrive and actively participate in their health care.
The coordination of services – physical, emotional and social – benefits all involved.
“By working together,” said Dr. Backus, “the healthcare team learns from each other to expand their skill sets.”
“Having a shared care plan that all providers in the practice can access facilitates communication among doctors, specialists, care coordinators and parents – and improves the care that the child and family receives,” Dr. Backus said. “With integrated care, we treat the whole person, the whole family – and that will strengthen the whole community.”
Integrated Care Improves Access and Patient Outcomes While Reducing Costs
Mental and behavioral health care plays a significant role in the prevention, diagnosis and treatment of the 15 leading causes of death in the United States, according to the Center for Disease Control. These are heart disease, cancer, stroke, chronic lower respiratory disease, accidents, diabetes, Alzheimer’s disease, influenza/pneumonia, kidney disease, septicemia, suicide, chronic liver disease, hypertension, Parkinson’s Disease, and assault/homicide.
The percentages vary by source, ranging from 20-85 percent, but most experts agree that some portion of primary care visits include a behavioral or mental health component.
While the conditions often co-occur, treatment does not. And that fragmented health care delivery system drives up medical costs, according to the American Psychological Association (APA). In fact, it costs two to three times more to treat people with chronic medical problems coupled with mental conditions than to treat people with physical health conditions only.
On the other hand, integrated care increases access to and quality of care, improves patient outcomes, and reduces health care costs. The APA also reported that:
- Only 14 percent of people with insurance are receiving treatment for mental health or substance use disorders, but they account for more than 30 percent of total health care spending.
- Effective integration of medical and behavioral care could save $26-$48 billion annually in general health care costs.