NYAPRS Note: Denver’s system is regarded by many as a national leader in behavioral and physical healthcare integration.
Primary Care Doctors Welcome Mental Health Professionals
By Yesenia Robles The Denver Post April 8, 2013
A growing number of primary care doctors in the Denver metro area are opening their doors to mental health professionals to help treat their patients - part of a trend toward integrating health services.
Mental health community centers in Adams and Arapahoe counties started placing their professionals in private doctor's offices more than five years ago, but officials say they are finding more and more general practice doctors who understand the benefit of on-site counseling services.
The Jefferson County mental health center started its co-location program 14 months ago and now has mental health professionals in seven primary care offices.
"It's just good care, and it's becoming the standard of care," said Jill Atkinson, clinical director at Adams County's Community Reach Center. "Providers are much more confident."
Rather than sending patients away with a scribbled phone number and telling them to make an appointment with a psychologist, these doctors can pull the in-house clinician into a patient's room for an instant consult.
Sometimes they will schedule another appointment. Other times patients just need someone to talk to for a few minutes or to give them some tips.
Dr. Helen Story, a primary care doctor at Family Care Southwest in Littleton, said she saw the need to integrate psychologists as more mental health problems were presenting as physical symptoms.
"They would think they were seeing a sore throat and really it was depression or anxiety," Story said. "They felt at sea."
Some of the issues the integrated psychologists help patients address are matters that patients think are minor and thus aren't likely to seek professional help on their own, experts said.
Day-to-day workload varies but can include talking to children who aren't taking their asthma medicine, counseling overly stressed parents or helping patients having trouble adjusting to a newly diagnosed chronic disease.
"Every problem has some sort of psychological overlay," said Dr. William DeLano, a doctor at Arapahoe Park Pediatrics who also is working with an integrated mental health professional.
The correlation between physical and mental health is already being documented.
According to a study cited in a2012 report by the Colorado Health Foundation, 68 percent of adults with behavioral health disorders have at least one physical health condition, and 29 percent of adults with a physical health condition also have a mental health issue.
For example, roughly one in five people who suffer from heart attacks become severely depressed, the report states.
But barriers to serving more people or improving communication among doctors and psychologists remain - including managing different financial processes and having incompatible record systems.
The Colorado Health Foundation's report states that sustainability is a concern when as many as 75 percent of the integrated health sites they surveyed are funded primarily by grants.
While some health care reform changes are expected to help, experts say state advocates are also pushing for changes in billing processes.
In the meantime, Colorado sites are still collecting data to show that integrating various health professionals in one center has an impact on patient health.