[NYAPRS Enews] Report on Integrating Health/Behavioral Health Lauds Massachusetts Initiative

[Harvey Rosenthal]

NYAPRS Note: The following excerpts come from "Mind and Body Reunited:
Improving Care at the Behavioral and Primary Healthcare Interface",
which was prepared by Barbara J. Mauer, MSW CMC and Benjamin G. Druss,
MD, MPH  for the American College of Mental Health Administration, the
National Council for Community Behavioral Healthcare and the Carter
Center Mental Health Program and distributed at ACMHA's recent March
2007 annual Summit. 

The report cites promising results from embedding a nurse practitioner
within a mental health program that was one of several integrated
approaches used by the Massachusetts Behavioral Health Partnership.

Dr. James Thatcher, Medical Director for the Partnership, will be
providing details about these initiatives and their results at the
upcoming NYAPRS Executive Seminar on Transformation, to be held June
21-2 at Albany's Crowne Plaza Hotel. For more details, please go to
http://www.nyaprs.org/PDF/ex.sem.pgs.pdf 

 

"Nearly every major policy statement on mental health in the last
decade, ranging from the Surgeon General's Report to the President's New
Freedom Commission on Mental Health, has begun with the tenet that
mental health is central to overall health and more recent reports have
added a corollary-physical health is central to mental health.

 

Improving the treatment of mental and substance use disorders in primary
care settings and improving the medical care of people with serious
mental health (MH) and substance use (SU) disorders served in behavioral
health (BH) settings has been a growing area of focus over the last
decade. The goal of achieving quality of services and outcomes on both
sides of the primary care/behavioral health interface is gaining long
overdue attention and emphasis. This paper seeks to review the history,
structure, and current developments of care at the primary
care/behavioral health interface. It focuses on care in the public
sector, where high rates of comorbidity, regulatory burdens, and lack of
resources create particular challenges in providing care at that
interface...."

 

"To date, only a handful of effectiveness trials have assessed
strategies to improve medical care in patients with (mental health and
substance abuse) disorders. However, the results from these trials are
quite promising, demonstrating that a range of strategies appear to be
effective in improving linkage with, and quality of, medical care, and
improving self-reported health outcomes in groups with higher levels of
baseline medical comorbidity."

 

"...A Massachusetts behavioral healthcare network that is part of a
community-based healthcare delivery system initiated a performance
improvement project focused on adults with serious mental illness. They
chose to embed a nurse practitioner within the mental health setting,
creating one-stop shopping in a familiar environment. Patients were
randomly assigned to experimental and control groups. The experimental
group received routine primary healthcare from the nurse practitioner.
Those in the control group received treatment as usual with regard to
their primary care. One goal was to reduce ER visits; ER visits were
actually 42% lower in the experimental group compared with the control
group. The most dramatic differences were found in the healthcare
screens for hypertension and diabetes. For both indicators, the
experimental group experienced a 44% rate of access compared with 0% in
the control group."

 

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