From the Summer 2017 issue of AtlanticView:
Primary care screenings advance mental health treatment
Depression or anxiety can strike anyone, but millions of people with mental illness never get treatment. And the statistics for those suffering from alcohol and substance misuse are especially dire: Up to 90 percent of individuals are not receiving treatment for their substance misuse, according to a 2016 report by former Surgeon General Vivek Murthy, MD.
According to Thomas Zaubler, MD, chairman, Department of Psychiatry, Morristown Medical Center, barriers to care include stigmas associated with mental illness or substance misuse, a lack of psychiatrists and mental health professionals, and access to affordable care. But a program at Atlantic Health System aims to fill the gap in outpatient psychiatric care by integrating mental health and substance misuse screening and treatment into the primary care setting.
“Eighty percent of antidepressant prescriptions are written by primary care doctors because there are simply not enough mental health professionals to treat psychiatric illnesses,” says Dr. Zaubler. “In our program, each patient is screened for depression, anxiety and other psychiatric issues. A supervising psychiatrist reviews and makes recommendations for patients who need medication, and the primary care doctor does the prescribing.”
An Integrated Care Model
Dr. Zaubler says a full-time master’s prepared clinician provides psychotherapy services as well as care coordination for those patients also being treated for a medical condition such as diabetes or heart disease. “They track patients to make sure that their depression or anxiety is getting better so no one falls through the cracks.”
Physicians also screen patients for alcohol and substance misuse, and those needing treatment meet with a clinician. If patients need a higher level of care, they are referred to an Atlantic Health System outpatient treatment program or a rehab facility.
This collaborative care model is being integrated into a pediatric primary care site and is expected to expand to additional adult primary care practices over the next several years. Dr. Zaubler says patients like having the service integrated with their primary care treatment.
“Patients are thrilled and the doctors love it, so the feedback is very positive. We have patients who probably have never received any care for their depression or anxiety before this program. We see this as the future of mental health care.”