Can integrated care improve psychiatric patient outcomes?
Key Takeaways
Integrated care combines mental health services with other primary care or specialty medical services in one centralized location.
The integrated care model has been shown to improve patient outcomes, lower costs, and boost quality of care.
Providers can implement integrated practice components relatively easily, but some barriers may arise.
As healthcare providers search for better ways to optimize patient outcomes, the integrated care model has emerged as a highly beneficial method of enhancing coordination and communication among patients and healthcare workers.
Unlike traditional delivery systems, integrated care combines psychiatric care with primary or specialty services, such as oncology or women’s health, in one central location.[]
Increasingly, integrated care has come to mean the absorption of primary or specialty medical providers into psychiatric practices.
This approach, especially for those with severe or persistent mental illness, may help improve the overall physical health of patients who don’t seek treatment elsewhere.
More agencies have committed to implementing integrated healthcare delivery models in clinics around the country. Therefore, it’s essential that behavioral health providers understand how the model benefits patients and impacts public health.
The case for integrated care
Mental illness and substance use are prevalent in the US—about 50% of its population struggles with these issues. It’s been estimated that about half of those affected received care from a behavioral health provider, while the other half saw primary care providers.
The stigma surrounding mental health care, together with lack of access (in part to provider shortages) and the underdiagnosis of mental health disorders by general practitioners, may drive some patients away from much-needed specialty mental health care.
Other research confirms this finding, including a 2015 study that found only about 20% of adults with mental health issues receive treatment from mental or behavioral health specialists.[]
However, integrating mental health services into other types of practice has been shown to:[]
Boost the quality of care provided
Improve access to mental health services
Lower total healthcare costs for the patient and the healthcare system
Reduce symptoms of mental health problems, such as depression
Different care models
According to the Substance Abuse and Mental Health Services Administration, integrated healthcare may be categorized in the following three ways:[]
Integrated program: This type of organizational structure addresses all of the patient’s needs by ensuring they’re connected with appropriate staff members or linked with other programs.
Integrated system: This structure uses funding, credentialing/licensing, needs assessment, data collection/reporting, planning, and other systemic and operational functions to support a variety of programs for patients with different needs.
Integrated treatment: This refers to the interactions and work occurring between behavioral health providers and other clinicians to address the individual and varied needs of each patient.
Since mental health conditions often occur simultaneously with general health problems, adopting an integrated care model can improve the quality of care provided while addressing the full spectrum of the patient’s needs.
Implementing integrated care
The successful implementation of integrated care models into practice requires adherence to several key components, including:
Formation of a multidisciplinary care team
Screening, evaluation, and referral to integrated care
Decision-making support for care that is stepped and measurement-based
Exchange and tracking of information among care providers
Links with social services and other community resources
Self-management support that is culturally adapted
Quality improvement across the entire system
Successful implementation also necessitates identifying barriers that may hinder integration.
A 2020 survey of providers by the Commonwealth Fund identified internal and external barriers to integrated care.[] These included regulatory or policy-related barriers, as well as barriers caused by organizational structures and facility processes.
Such barriers may include insufficient health IT infrastructure, low buy-in from primary care providers, lack of reimbursement, and insufficient physical space for providing healthcare services.
As agencies like the Centers for Medicare and Medicaid continue to introduce billing and reimbursement options supporting integrated care, clinicians should expect the trend toward this care model to continue, ideally leading to an overall improvement in public health.
What this means for you
Integrated care models are increasingly in use among healthcare facilities. Clinicians can support improvements to public health by working closely with other healthcare providers to address the full spectrum of mental health patients’ needs.