Mental health and medical professionals often treat clients from two very different perspectives, seldom integrating their skills for the betterment of client care. Current modifications in healthcare may quickly be altering the way primary and behavioral health care providers offer services to clients. Integrated Healthcare is a movement, new in Michigan, in which doctors, nurses, psychiatrists, behavioral health specialists, and therapists work together to provide support for one another and, more importantly, the client. In the Integrated Health Care Model, physicians and
behavioral health consultants work together to meet the behavioral concerns presented by clients. Many physical and behavioral concerns may occur simultaneously, such as a client having symptoms of a depressive episode who also has issues with her or his thyroid. Through an integration of physical and behavioral methods, primary medical care provider offices can meet a wider range of client needs. Typically, the pediatrician is the most
trusted professional in a child’s life and is the first who parents consult when they have concerns regarding their child’s well-being and health. According to Gruttadaro and Markey (2011), up to 70 percent of primary care appointments are due to psychosocial concerns. More than half of all primary care visits are for common mental health conditions including anxiety, depression, attention-deficit/ hyperactivity disorder (AD/HD), and related conditions. Due to this special relationship, pediatricians and family doctors are in a unique position to identify early mental health concerns and link the family with the appropriate referral and support. Despite being one of the first professionals to hear parents’
behavioral concerns of their children, very few primary care professionals (PCPs) have advanced training in behavioral pediatrics (Pidano, Meyers, & Honigfeld, 2011). Barriers arise in the management of psychiatric medications such as lack of time within the PCP’s practice, inability to access consultation from specialists, lack of referrals to mental health professionals, and inadequate insurance coverage for providing behavioral health services (Pidano et al., 2011). By having therapists housed in the same office as the PCP, there is an improved access to care and a reduction in stigma (Gruttadaro & Markey, 2011). The therapist can work closely with the family’s doctor and psychiatrist on staff to ensure clients are evaluated for the appropriate medication, if
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needed. Also, the therapist can increase the consultation and collaboration between the appropriate professionals on the client’s behalf. Thanks to the research of Felitti et al. (1998) on the impact
of Adverse Childhood Experiences (ACEs), the association between childhood abuse and adult health risk behaviors and disease is becoming clearer to health care professionals. ACEs consist of any of the following situations that occurred in childhood: abuse including the following categories psychological, physical, or sexual and household dysfunction,
In the Integrated Health Care Model, physicians and behavioral health consultants work together to meet the behavioral concerns presented by clients.
which includes parental substance abuse, mental illness, domestic violence, criminal behavior, and poverty. Many of these categories used in the ACEs study are reasons people seek out therapy. However, due to stigma surrounding mental illness, individuals with an ACEs history may not know how to find a therapist or will not seek help until the trauma develops into a physical ailment or disease. Having a relationship between medical and mental health professionals is crucial in cases such as these. Having mental health professionals present through the integrated approach, PCPs would have a better understanding of the types of behavioral symptoms associated from an ACEs history in a client’s background and make the appropriate referral to a mental health professional. Felitti and colleagues (1998) observed a direct correlation between the number of ACEs present in an individual’s
September 2014 | PLAYTHERAPY 7
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