Integrated Medicine. Coordinated Care. These are terms we are hearing more and more these days. But what do they mean and why should the general population care? The answers have to do with the fact that integrated and coordinated care is better for the patient, for families and for communities.

Integrated healthcare means providers are working more closely together to ensure patients have access to the services and experts they need to help them be healthy physically, mentally, emotionally and spiritually. Integrated health needs require integrated health care.

There is no denying the connection between the mind and body and recent data shows that a large number of primary care visits in the United States are related to behavioral health needs, as well as physical needs.

Dr. George Hershey, D.O., medical director and a family practice physician at NACA’s Family Health Center and team physician for student-athletes at Northern Arizona University since 1971, helps explain the correlation between physical and behavioral health needs and the need for more integrated care.

“Many common medical problems seen in primary care involve poor health habits that may start, continue or worsen the illness or symptoms and contribute to other health needs. Often, individuals receiving care for physical health conditions may also require care for behavioral health conditions, and vice versa.

“Unfortunately, our healthcare systems tend to operate independently, without coordination, resulting in gaps in care, inappropriate care and increased costs. Hence, the need for integrated care, which is the coordination of general and behavioral healthcare. It incorporates mental health, primary care, physical lifestyle changes and substance abuse services.

“Integrated care has many levels of care including screening, preventative, intervention, communication, education and wellness. Care begins with screening patients for conditions in addition to the ones they present with or come to see a provider for. Questions and screenings for physical conditions should be accompanied by questions and screenings regarding mental health.”

These coordinated and integrated services are paramount to the health of the individual. For example, people with mental or substance abuse disorders typically die years, and even decades, earlier than the average person. Most often, they die from untreated and preventable chronic illnesses.

The Center of Integrated Health Solutions reports:

· As many as 70-percent of primary care visits are related to behavioral health needs.

· Sixty-eight percent of adults with mental illness have one or more chronic physical conditions.

· One in five adults with mental illness also have a substance abuse disorder.

· Chronic health conditions such as high blood pressure, heart disease, diabetes, sleep problems, pain disorders, obesity and asthma are significantly higher in those who have a mental illness.

· If someone is suffering from depression, they are likely to be experiencing some physical ailments as well.

“The solution lies in the systematic coordination of mental health, primary care and substance abuse services,” Dr. Hershey explained. “Integrated care is the most effective approach to caring for the whole person, especially those with multiple and complex needs.”

Integrated care has been shown to reduce emergency room visits, hospital admissions and overall medical costs. That’s because integrated care allows:

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· Improved access to primary care services.

· Improved prevention, early detection and intervention to reduce the incidence of serious physical illness and chronic disease.

· Improved screening, detection and intervention of behavioral and substance abuse conditions.

· Improved overall physical fitness and health of patients.

Often the physical distance between medical and behavioral health providers can present a barrier to providing coordinated care. This distance can mean decreased communication between physicians, increased time between office visits and treatment, higher costs and ultimately poorer health outcomes for patients.

Fortunately, community health centers, like Flagstaff’s NACA, Inc. and North Country HealthCare, are leaders in the cohabitation of physical and behavioral healthcare at the same location. Some community health centers also work to integrate a wellness component into the overall care by providing a place, like NACA’s Wellness Center, that offers nutritional guidance, exercise programs, educational classes and community outreach.

At North Country HealthCare, behavioral health counselors are also part of the medical team. These counselors educate individuals and families on making lifestyle changes and are trained to work with individuals, families and small groups. They also provide short-term counseling services in areas such as stress, anxiety and depression; work with the patient to create a plan to achieve positive health outcomes, manage health challenges and diagnoses; and provide referrals to outside agencies as needed.

“The goal of integrated healthcare is to deliver patient-centered, culturally sensitive behavioral and physical health assessments, care and interventions to each person,” Dr. Hershey said. “Integrated care means quality care for the body, mind and spirit.”


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