People with serious mental illness die, on average, twenty-five years earlier than those in the population without a serious mental illness. This consideration reaches a level of urgency when you consider that the causes for this statistic are due largely to treatable medical conditions that remain unaddressed.
If we, as peer support specialists, are to truly support those towards wellness and recovery then the whole person and their whole health must be brought to the table.
Peer discussions and peer efforts are now taking place with SAMHSA's Center for Integrated Health and the The National Council for Behavioral Health are working at a national level to see that Integrated Health comes to full realization. Whole Health Action Management (WHAM) Training offered by CIHS and Peer Health Navigation Training offered through Pacific Clinics in Southern California are examples of how peers are leading the way in being the ambassadors for wellness and integrated health for those with mental health challenges.
Bazelon Center for Mental Health Law provides a very helpful report entitled "Get It Together: How to Integrate Physical and Mental Health Care for People with Serious Mental Disorders" that offers a helpful framework in discussing the need for whole health and integrated health for those we are called to support.
This report shows ways of improving integration and coordination of behavioral health and primary health services for adults and children with serious mental health challenges. This study focuses on integration of care and the challenges facing a fragmented system and ways to move towards an integrated and recovery-oriented system.
The report shares some important barriers that typically stand in the way of integrated health efforts which include:
Barriers to Integrated Care
- Patterns of financing create problems
- Cultural differences lead to isolation
- Training is key
- Needed services are often unavailable
- Information-sharing is essential but difficult
- Consumers concerns to be heard
They go on to share some helpful insights in ways to overcome these barriers and challenges in moving towards a more integrated approach as follows:
Ways to Overcome
- Primary care to be embedded in a mental health program
- Unified primary care and mental health programs to be developed
- Policy for integrated approach to be developed
- Providing start up funds for establishment of embedded or unified programs
- Stipulating the requirements that mental health agencies furnishing on-site primary care to meet
- Ensuring that reimbursement rates reflect the cost of providing services and the time spent on care coordination
- Placing the responsibility for primary care services to individuals with serious mental illnesses clearly on one entity
They end by offering some very helpful considersations in ways that we can begin to encourage collaboration in physical and mental health care which include:
Ways to Encourage Collaboration
- Initiatives to improve communication and understanding between the two fields can be built into contracts for public care.
- Access will be improved if primary care providers receive information on local mental health resources and how to access care from the public mental health system.
- Funding strategies include the use of performance measures
- Agencies can provide educational materials and organize continuing education programs to help primary care providers acquire the skills to work withindividuals with serious behavioral health disorders.
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