MDNews - Minnesota

January 2014

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SPECIAL CLINICAL SECTION: MENTAL HEALTH 16 BRINGING Behavioral Health Care to the Front Lines By Michael Ferguson INTEGRATING BEHAVIORAL HEALTH TREATMENT INTO THE PRIMARY CARE SETTING MIGHT HELP REMEDY THE BEHAVIORAL HEALTHCARE SHORTAGE, EVEN AS THE AFFORDABLE CARE ACT EXPANDS COVERAGE FOR SUCH PROBLEMS. B EHAVIORAL HEALTH CONCERNS, such as depression, often arise comorbidly with diabetes or cardiovascular disease, but because primary care physicians are tasked to manage surging caseloads, they often don't have adequate time to address behavioral health concerns. Dennis S. Freeman, PhD, CEO of Cherokee Health Systems, committed to providing integrated behavioral and primary care outreach in 1969. Early in his career, he was struck by how much behavioral health factored into primary care — and how patients often preferred | Twin Cities MD NEWS ■ MDNEWS.COM to be treated in that atmosphere. "The data is pretty clear that when medical [practitioners] refer to behavioral health, less than 20 percent ever really connect for treatment," Dr. Freeman says. "[Primary care is] the best environment to treat people for all kinds of behavioral issues, and I'm not just talking about mental health diagnoses, but also people not progressing well in managing their chronic illnesses. It makes sense to see these people in primary care." Since 1984, clinics under the East Tennessee-based Cherokee Health Systems umbrella have incorporated behavioral care into the primary care setting. Dr. Freeman notes the key is hiring people who can thrive in a non-traditional mental health practice. Cherokee Health Systems' behavioral health consultants — generally psychiatrists — need to be able to treat any condition patients present with. The process is seamless — primary care providers meet with patients and simultaneously identify internal medical conditions as well as any behavioral

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