Last week I introduced the topic of integration of primary and behavioral health care. I’ve been listening to some podcasts about it (got to love those) and heard about an interesting system a local hospital is piloting. Each general care practitioner clinic is required to have a behavior health professional on staff. That professional has two roles.
- See individuals referred by the general care staff.
- Keep the staff current on new mental health medications and research.
Evaluations of the program have been positive thus far. The primary care physicians have seen a dramatic decrease in the resistance of individuals in scheduling and attending an appointment with a mental health counselor. The doctor will write a note in the individual’s chart, and when they check out the receptionist will ask when they would like to schedule an appointment with the mental health professional. Often, they are able to make same or next day appointments. Moving the mental health professionals into the same clinic as the primary care doctor increases convenience and lessens the stigma attached to therapy. The clinic has found the convenience of same day appointments is especially beneficial to low income individuals who have transportation concerns.
I love this idea—and will be interested in seeing if it spreads throughout the larger Indiana community. I’m not ashamed of therapy—but I still have some awkward moments in the waiting rooms. Everyone there is trying to avoid eye contact with you, and you start wondering why they are there. And figure they are trying to figure out why you are there……or what if you run into someone you know? What’s the protocol on that? So sometimes I think it would be nice to park my car in my general care doctor’s office, and sit in the waiting room. Then people could just assume I was there for an allergy shot or something.
But now I need your opinion on something! The administrator presenting the pilot project, said one of the most basic problems they are encountering is a debate between primary care practitioners and mental health practitioners. Are individuals being seen by mental health practitioners “patients” or “clients”? Primary care practitioners identify them as “patients” the same as every other individual they see. Mental health practitioners believe they should be addressed as “clients”.
Seems like a simple concern—but there’s actually a lot riding on this debate. I see the case for both sides.
- Client: The connotation is of the individual having more responsibility and control over their treatment.
- Patient: This connotation brings to mind someone who is sick—on one hand, I think that can be a good thing. I want to start to associate this anxiety/depression crap with physical illnesses so people realize it’s not my “fault”. But on the other hand, not everyone in therapy has a physical illness and sometimes when I am doing well I do not like to think of myself as sick.
So—I can be swayed either way on this issue! VOTE and then leave a comment with your thoughts on why you voted the way you did (if you would like to!)