Why Integrated Behavioral Health Care Leads to Better Results
For a long time, traditional medical care systems kept mental health and physical health concerns and treatment plans separated. This attitude is now shifting due to a deeper understanding of the link between mental health and physical health conditions. Now, the need for integrated behavioral health services is clearer than ever.
This new model of collaborative care is an essential patient-centered approach. It provides you and your loved ones with comprehensive, whole-person healthcare.
Understanding the role of integrated behavioral health services in today’s medical care landscape is essential to finding the best possible care for you and your loved ones.
What Is Integrated Behavioral Health?
Integrated behavioral health services (IBHS) combine mental and physical healthcare into blended treatment plans. While previous healthcare systems fragmented them into different silos, integrated behavioral health creates a collaborative care team of health providers and even social workers.
The Start of Integrated Mental Health Services
The need for behavioral health integration was discussed as early as 1928 by prominent psychiatrist Adolf Meyer. The American Journal of Psychiatry states that he foresaw a shift in the field where mental health providers would need to integrate into clinics in order to care for the community.
It wasn’t until the 1980s that clinicians and researchers truly became interested in what integrating mental health care could do. During the 1980s to the 1990s, evidence-based studies were conducted that advanced our knowledge of mental health conditions and their relationship to physical illness — and the importance of IBHS truly came to light.
Why We Need IBHS
Integrating behavioral health and other human services, such as social work into primary care settings, is an important step to address modern medical needs. In fact, due to rising medical costs and mental health conditions, it’s more important than ever.
Behavioral Health Crisis
One of the most pressing issues driving the need for integrated behavioral health services is the rise in mental health conditions. Mental health and addiction issues have been on the rise, especially since the COVID-19 pandemic.
Rise of Mental Health Issues
Young people’s mental health has been especially vulnerable. According to the CDC, more than 42% of students reported struggling with persistent sadness in 2021. Young people today face unique stressors from societal changes, including economic instability, isolation during the pandemic, and widespread social media use. All of this has led to a drastic increase in mental disorders among children and adolescents.
The pandemic also affected adults. Since 2020, there have been more recorded incidents of many mental health conditions. Depression rates rose 20% between 2021 and 2022, with 36% of women reporting that they have been diagnosed with depression.
In the same time span, anxiety rates increased by 33% and more incidents of PTSD have been reported among the general population. Additionally, 17.3% of the population over the age of 12 struggled with substance abuse disorders in 2022 alone.
These numbers show a pressing need for greater access to mental health services than traditional, siloed medical care models provide.
Rise In Substance Abuse Issues
Substance use is an ever-rising issue in the United States. Deaths caused by overdoses have increased from 8.2 deaths per 100,000 in 2002 to 32.6 per 100,000 in 2022. Opioids and stimulants are the primary cause of overdoses and a large part of the substance use epidemic that the U.S. is facing.
However, alcohol use disorder is also becoming more common, as are alcohol-related deaths. Since 2016, the rate of alcohol-related deaths has increased by 29%.
Since COVID-19, the already growing number of substance use disorders has been exacerbated. IBHS gives people struggling with substances greater access to addiction-informed mental health professionals that help them develop a path to recovery.
Physical and Mental Comorbidities
The current rise of mental health issues is also a threat to our physical health. Your physical well-being and mental well-being are connected more than you might think. In fact, struggling with a mental illness lowers your life expectancy by 10 to 25 years. This difference is mainly caused by physical health.
When struggling with an untreated mental illness, it is harder to care for your physical health, making you more vulnerable to developing health issues. Conversely, when you have a serious physical illness, you’re at a greater risk of developing a mental health issue.
Not only that, but our physical health impacts our mental health as well. When you go through a major surgery such as a joint replacement, your recovery timeline may not match your expectations. IBHS gives you access to a mental health professional who can help you manage the emotional aftermath of your procedure.
From working through fertility issues to facing a major, life-changing diagnosis, medical care can cause a lot of deep feelings, including frustration, stress, and even depression. With IBHS, you have the space to work through those feelings, and since your doctor is working alongside behavioral health professionals, it’s much easier for them to address them as well.
Treating psychiatric care and physical care as separate fields fails to address how they impact each other. Integrated behavioral healthcare means better collaboration between general practitioners and mental health care providers. As a result, you receive better care for both your mind and body, leading to better health overall.
The Benefits of Integrated Healthcare
IBHS helps address the rising mental health crisis and the link between our minds and bodies to provide better patient outcomes.
Increased Efficiency and Collaboration
Incorporating IBHS services fosters a team-based approach to patient care into one unified system. This streamlines communication and access to patient records, leading to more coordinated care plans.
The coordination means that all aspects of your health are considered when you receive a diagnosis, all without waiting for patient records to be cleared between separate systems.
Increased Affordability
Merging healthcare services eliminates extra administrative costs from housing them in separate systems. When you receive care from a facility that integrates primary care and mental health services, you could save over 800 dollars per year.
Not only that, but integrated models lower your cost of healthcare in general. When you receive care from an integrated primary care system, you are far less likely to visit the ER, and the average length of time you need to stay in the hospital decreases.
Increased Accessibility
Mental health services are more readily available when incorporated into a primary care setting. You can easily address your health without referrals to specialists or seeking out specialized clinics.
IBHS is especially important in areas that have limited health resources. Making access to mental health services easier increases the likelihood that people will get the behavioral interventions they need.
Accessibility is crucial if you are actively struggling with a mental health condition – but therapy can also be beneficial if you aren’t. Psychotherapy treatments such as cognitive behavioral therapy (CBT) are effective for everyone – even those without a mental health condition. We all go through stressful situations throughout life; psychotherapy and stress-management techniques can benefit us all.
Addressing Issues Early
Because an integrated approach makes mental health services more available, it’s more likely that you can address stressors and circumstances early — before they develop into more serious mental disorders later.
This is especially important when it comes to the mental health of children and adolescents. Many mental illnesses develop before the age of 25, yet young people often have the poorest access to mental health services and screenings. Even when they do receive treatment for their mental health, they often experience delays in receiving it.
Younger people are more likely to see their general healthcare provider for their mental health. However, without an integrated approach, general practitioners have difficulty diagnosing mental issues — and managing them after. By having high-quality adolescent mental health services incorporated into a primary care setting, it is less likely that young people will fall through the cracks and miss out on the care that they need.
Early intervention reduces the severity of symptoms and keeps issues from getting worse later.
Ending Stigma
One of the most important benefits of an integrated healthcare system is a reduction in stigma surrounding mental health issues.
People feel more comfortable receiving mental health services when they are incorporated into a primary care setting. This – on top of the convenience – is one of the reasons more people participate.
Not only that, but IBHS models encourage cross-disciplinary collaboration and education. Stigma within the medical community itself is one of the reasons for the difference in mortality rates between those without mental health issues and those with them.
Both patients and other medical professionals have indicated that some primary care doctors treat patients suffering from mental health concerns, such as substance use and depression, with bias – sometimes making disparaging comments, over-medicating them, or ignoring their health complaints.
When primary care doctors and licensed mental health professionals collaborate, communicate, and educate one another, these biases are stripped away. Reducing stigma leads to better health outcomes, medication management, and relationships between patients and doctors.
Better Relationships With Patients
When primary care providers understand you as a whole person and know both the status of your physical and mental well-being, it creates a stronger relationship. This relationship means more patient-centered care that positions your needs at the heart of the treatment plan.
The stronger relationship allows for a more active partnership where you collaborate with your healthcare providers and participate in the decision-making about your treatment. This active relationship leads to higher patient satisfaction overall.
Challenges IBHS Face
Despite the need and benefits of integrating behavioral health services into a primary care setting, it still faces challenges before it’s completely adopted.
Provider Shortages
As the need for mental health services has grown, so has the demand for professionals in the field and the shortage of mental health professionals is projected to continue to rise into 2036.
Rural areas in particular have a worse shortage of mental health providers, often depending on primary care physicians for mental health services. Underserved urban communities also suffer from a lack of access to mental health providers. Because of this, these communities often have longer wait times for patients and increased provider burnout.
For the integration of behavioral health services to be successful, it’s important to attract and retain providers in critical mental health fields.
Organizational Biases and Structures
IBH requires a shift in organizational structures that many resist. Providers and clinics must remodel how care is delivered, funded, and managed.
Not only do we have to overcome some personal biases when it comes to mental health – but we also have to overcome provider’s reluctance to adopt new practices. Fee-for-service structures and methods of sharing patient information need to be updated when behavioral health services are integrated, and some providers resist these changes.
Lack of Resources
Integrating mental health services can be a costly process. Clinics may need to expand their space or invest in new technologies, so many resist adopting a collaborative care model.
How to Overcome Issues
Policy Changes
Structural changes can be encouraged at the state and federal levels with proper policy changes.
We can encourage more providers to join the field with educational grants and loan repayments, especially policies encouraging mental health providers to work in underserved areas.
Policies and incentives that encourage the integration of behavioral health services into primary care settings and expand the kind of coverage that insurance is required to carry would also help make this model of care more accessible.
More Funding
Grant opportunities targeted at integrating mental health services encourage more healthcare providers to adopt this model. For programs that have succeeded in integrating mental health services, grant funding is a key component in their success.
Diverse funding streams are also important for a clinic’s success in integrating mental health services. Meridian HealthCare provides integrated behavioral health services thanks to the generous support of many organizations such as the US Department of Housing and Urban Development, the City of Youngstown, and private foundations and individual donors throughout our community.
Collaboration
Integrating behavioral health services into a primary care setting requires collaboration between providers — but it doesn’t stop there.
Partnering with other clinics and organizations and sharing data-driven best practices can help streamline the integration. Pulling together expertise and resources increases the services that healthcare providers can provide, not only when it comes to inpatient and outpatient services, but also educational and social programs. Meridian HealthCare’s collaboration with AmeriHealth Caritas Ohio led to an innovative pain management educational program that empowers those living with chronic pain to live fuller lives without the use of addictive painkillers.
The most successful integration also comes from community involvement. When the community is active in supporting and directing IBHS, initiatives are more likely to be developed in a way that serves the community’s needs.
Better Healthcare Begins With Integration
Though we’ve been making strides toward more integrated behavioral health services in the past few decades, work still needs to be done to make them as accessible as possible.
With rising reports of mental health issues, it is essential that we make strides in offering behavioral health support to those who need it, especially vulnerable populations. If we want to start seeing an increase in mental health, then we must be proactive in integrating these services into more primary care settings.
While we haven’t reached a point where IBHS is a staple in modern medicine, there are still plenty of clinics where you can find on-site mental health services alongside primary care services. At Meridian HealthCare, we employ a collaborative care approach that integrates behavioral health services with primary care and medication-free approaches to pain management through acupuncture and chiropractic care. We’ve been working with and in our community for the last 50 years, and have seen first-hand the moments of hope that can grow from comprehensive integrated behavioral health services.
