Integrated Mental Healthcare Post #1: Improving Access to Mental Health Care
Updated: Dec 6, 2019
Mental Health is a growing concern in the health of the aging population. Aging impacts people both physically and mentally, and this decline can impact daily functioning and social roles and responsibilities. This opinion article by CBC discusses the impact of psychotherapy in mental health. But there is much more that can be done. In this blog, we will look at In this first Mental Health blog post, let’s talk about improving access to mental health care, specifically in the primary care setting, and how that can be approached with integrated mental healthcare.
According to Patel et al. (2013), “[w]hen mental health problems are not effectively treated, they can impair self-care and adherence to medical and mental health treatments, and are associated with increased morbidity and mortality, increased health care costs, and decreased productivity.” This branches off the inference that our physical and mental health are interrelated.
Integrated care is “a general term for any attempt to fully or partially blend behavioural health services with general and/or specialty medical services” (American Psychiatric Association, 2019). This means that the approach to behavioural health services doesn’t exclusively mean mental health care and psychiatrists and psychologists, but also involves a holistic team including a general practitioner, pharmacist, dietician and other health practitioners. WHO discusses that recognition of diagnosis and health promotion are also essential elements to the scope of integrative mental health care (WHO, 2017). This encompasses a holistic perspective, personalized or individualized care, patient-centeredness and a focus on wellness (Kania-Richmond & Metcalfe, 2017). This creates a team-based approach where mental health care and general medical care are offered in the same setting. Coordinating primary care and mental health care in this way can help address the physical health problems of people with serious mental illnesses.
“So why don’t we provide preventative measures to those struggling with mental health issues?”
Effective treatments exist for most common mental health problems, but few patients have access to treatments. Adequate access to mental health specialists is a challenge, and almost a long process. Full integration involves a single health system’s medical and mental health care providers working simultaneously to treat a patient’s behavioural and medical needs with shared medical record access (National Institute of Mental Health, n.d.). We understand that proper communication between practitioners with various expertise can give the best level of care possible. An ideal situation can be portrayed in this video below that shows a patient and how her community and practitioners collaborate.
Like a fully collaborative team is integrated, so is the health of the older adult. Mental and Physical health issues can be interrelated and thus the approach ought to be holistic. Having a collaborative primary care team can approach each aspect of care for the aging patient.
Integrated Mental Healthcare Sub-Post #1: What Does Aging Well Mean?
Seniors represent Canada’s fastest growing age group. It is predicted that 25% of Canadians will be over the age of 65 by the year 2036 (Horgan, 2019). Chronic health conditions include both physical and mental health issues (Horgan, 2019). So can one age well in one realm (eg. physical) and not in the other (eg. mental)? These are interrelated in that this assumption potentially may not happen!
Older adults are more susceptible to depression, anxiety, and lowered cognition. These are not meant to be considered a normal part of aging (Horgan, 2019). With proper treatment and support many of these issues can be addressed and resolved. These can be screened and prevented in the case of an integrated care. Without proper treatment and support these issues can become exacerbated and grow into more serious and chronic conditions (Horgan, 2019). Aging well requires preventative efforts and early detection in the primary care setting as aging does not have to include depression and cognitive impairment!
American Psychiatric Association. (2019). Integrated Care. Retrieved from: https://www.psychiatry.org/psychiatrists/practice/professional-interests/integrated-care/learn.
Horgan, 2019. Lecture.
Kania-Richmond, A., & Metcalfe, A. (2017). Integrative health care - What are the relevant health outcomes from a practice perspective? A survey. BMC complementary and alternative medicine, 17(1), 548. doi:10.1186/s12906-017-2041-4
National Institute of Mental Health. (n.d.) Integrated Care. Retrieved from: https://www.nimh.nih.gov/health/topics/integrated-care/index.shtml
Patel, V., Belkin, GS., Chockalingam, A., Cooper, J., Saxena, S., & Unützer, J. (2013) Grand Challenges: Integrating Mental Health Services into Priority Health Care Platforms. PLoS Med 10(5): e1001448. https://doi.org/10.1371/journal.pmed.1001448
World Health Organization. (2017). Mental health of older adults. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults.