The Neighborhood Health Association (NHA) continually strives to offer quality healthcare services to the uninsured and underinsured members of our community, as well as to identify opportunities to strengthen its care continuum and eliminate gaps in the services and resources provided. Recognizing a significant need for behavioral healthcare among the population it serves, NHA recently launched an Integrated Behavioral Health program to complement the wide-ranging medical services already available in its community health centers.
Jacque Caro, MSW, LISW-S, Director of Integrated Behavioral Health for NHA, explains, “This new program, which is funded through a grant from the Health Resources and Services Administration, is about meeting people where they are in the truest sense. Between 60 and 70 percent of people who are struggling with emotional issues go to their primary care provider for treatment because of the stigma associated with seeing a behavioral specialist. We’re filling that gap in order to give our patients convenient access to vital behavioral services as well as to help eliminate that stigma. We want people to be comfortable coming here whether it’s for emotional distress or the flu.”
To appreciate the degree to which stigma is encouraging people to turn to primary care providers when they need behavioral services, consider that 70 to 80 percent of the general population visits a primary care provider at least once each year, and out of that population, 70 percent of patients are seeking care for an issue related to emotional health. What’s more, research has revealed that 77 percent of depression medications are being prescribed by primary care providers, not behavioral health specialists.
In fact, though our culture tends to place physical and behavioral health in separate compartments, they’re more interrelated than many people realize. Caro notes, “Behavioral problems, such as chronic emotional stress or depression, have just as many functional impacts on an individual as physical problems do. Both can manifest themselves through symptoms such as weight gain or weight loss, headaches or other forms of pain, gastrointestinal issues, sleep disturbances, and many others. Also, chronic physical conditions, such as diabetes or heart disease, often have emotional side effects that need to be addressed.”
Furthermore, NHA’s clients tend to have an even greater need for integrated behavioral healthcare compared to the general population due to factors such as lower education level, lower income, lack of employment, exposure to violence or trauma, and other social determinants of health. Lack of transportation is also a major issue for many of the clients NHA serves. “If we try to send someone across town for a behavioral health appointment, there’s a strong likelihood that they’ll never get there. Our goal is to work with our clients using a whole-person model, not just treat their physical problems and send them elsewhere for behavioral issues. With our integrated program, they can see a behavioral health and primary care provider in the same day at the same location.”
Caro emphasizes that NHA’s Integrated Behavioral Health program is not intended to compete with other established behavioral health providers and agencies in the community. Rather, the program’s objective is to identify individuals who have emotional issues but might be reluctant to reach out for behavioral services so they aren’t allowed to slip through the cracks. She notes that what patients are willing to share with providers is often just the “tip of the iceberg.” Below the surface there can be significant emotional concerns that behavioral health professionals are trained to recognize.
According to Caro, integrating behavioral and physical healthcare also makes sense from the standpoint of dollars and cents. “Studies show that addressing emotional problems in a primary care setting reduces emergency room use by 54 percent, cuts overall medical costs by $500 per patient, and reduces hospital stays and office visits. Our program also helps ease the workload of medical providers who may not be comfortable addressing behavioral health issues and provides education to practitioners on how to recognize the signs and symptoms of emotional problems. It’s a collaboration that benefits everyone involved,” she says.
Neighborhood Health Association, through their exceptional health services, empowers and educates, aggressively working to eliminate healthcare inequities, while supporting personal responsibility for one’s own health regardless of the ability to pay.
To learn more about NHA’s Integrated Behavioral Health program or any other services that NHA provides, call 419-720-7883 or visit www.nhainc.org. ❦