A leading expert in the growing field of integrated health, UMass Medical School’s Alexander Blount, EdD, is calling for more mental health workers in primary care clinics and more primary care doctors in mental health facilities.
“More mental health care is provided in the primary care setting than anywhere else, including mental health care settings,” said Blount, clinical professor of family medicine & community health and psychiatry, in an opinion piece published in the latest issue ofHarvard Medicine, the Harvard Medical School magazine. Since most patients who receive mental health care in the primary care setting refuse referrals to mental health facilities, problems such as depression, anxiety, post-traumatic stress disorder (PTSD), alcohol and substance abuse and domestic abuse are “addressed in primary care, or not at all,” Dr. Blount wrote. Meanwhile, patients in mental health settings may have great difficulty accessing primary care services.
The answer, Blount argues, is to integrate primary care and mental health services, either by training mental health professionals to work in primary care settings alongside the primary care physicians who are currently carrying the load or by bringing primary care to mental health centers. Such integration improves access to services, shortens treatment courses and addresses health behaviors more effectively.
Blount is a pioneer and long-time advocate in integrated primary care and has helped establish UMMS as a national leader in this growing field. He is director of the UMMS Center for Integrated Primary Care, and director of behavioral science in the Department of Family Medicine & Community Health. The promise of an integrated approach was underscored with the establishment of the national Academy of Integrating Mental Health and Primary Care in 2010. Now, new payment approaches spurred by the Affordable Care Act, Blount said, are finally “making it financially possible to broadly implement the integration of behavioral health and primary care.”
Blount and his colleagues at the Center for Integrated Primary Care offer a growing number of training programs that focus on workforce development for the broad implementation expected to follow the introduction of new payment models. In 2007, the center launched the first program to teach mental health professionals how to work in a primary care setting. Since then, more than 1,500 mental and behavioral health professionals have attended these courses, which are taught by primary care behavioral health clinicians and primary care physicians from the family medicine & community health, medicine and pediatrics.
This spring, 450 participants are enrolled in the Center’s three programs: The Certificate Program in Primary Care Behavioral Health, the Certificate Program in Integrated Care Management for the Patient Centered Medical Home and the Intensive Training Program in Motivational Interviewing.
Demand for greater integration of primary care and mental health services will continue, Blount predicted, in light of “the growing evidence for increases in clinical effectiveness, long-term cost reduction, patient and provider satisfaction, and improved access.”