TULSA – The overarching message at this year’s Zarrow Mental Health Symposium was that to improve Oklahomans’ physical and mental health outcomes, providers must take a more holistic and collaborative approach to care.

More than 800 mental health care professionals attended the two-day symposium in Tulsa, which ended on Friday.

This year’s theme was “Mind, Body & Spirit,” referring to the need for greater collaboration and integration between primary physical care and mental health care.

Benefits of Holistic Care

Integration of mental and physical health care not only makes accessing those services easier, but helps reduce the stigma that has surrounded mental illness, said Dr. Susan Azrin, program chief of the National Institute of Mental Health’s primary care research program.

“Overall well-being is the culmination of many influences and the different types of health that contribute to our well-being, including health of the mind, body and spirit,” Azrin said. “They’re like multiple waterfalls streaming into a pool, and these streams all converge from the whole health of the person. Moving mental health care into the mainstream is very important to supporting the whole health of the person.”

Often, people seeking primary care will have untreated mental health issues, while people seeking mental health treatment will have undetected physical health issues, Azrin said.

Both the integration of mental health care into physical care settings, as well as the reverse, should continue, Azrin said.

“The interventions need to respond to the patient’s needs and they need to be compatible with actual practice patterns and the health-care system operations,” Azrin said.

‘One Overall Condition’

A range of physical conditions can be brought on by mental health medications, while a range of mental health conditions can be brought on by physical health medications and conditions, said Dr. Scott Grantham, who provides psychiatric consulting services for patients in the St. Francis Health System.

“The two types of health categories that we often think about are often really part of one overall condition,” Grantham said. “The brain illness affects the body, the body illness affects the brain.”

Dr. Gerard Clancy, vice president of the College of Health Science at the University of Tulsa, said only recently has there been a move to better integrate mental and physical health care.

“The need for integrated care has been talked about since the 1970s, but it really hasn’t gotten rolling until now,” Clancy said. “Some of those pieces have not been recognized as improving health – substance abuse, mental illness, addiction, health literacy. Those things really haven’t been recognized as much of a contributor to improving health. But today, those things are starting to change.”

The Business Side

Recent health care reforms such as the Affordable Care Act have “shaken things up” and caused more of an emphasis to be put on integrated care, Clancy said.

However, employers, governments and insurers are still looking for ways to drive the cost of health care down, Clancy said, and integration of services and value-driven care reimbursement models (which are more focused on patient outcomes) are some of the ways being considered.

“In the United States we spend more than any other country on health care and our health outcomes are in the bottom third of developed counties,” Clancy said. “That should be a call to action for all of us.”

Compounding the issue, projections show the supply of doctors and nurses is falling short of growing demand, Clancy said.

“We’re not going to be able to graduate enough doctors to do this work,” Clancy said. “It requires us all coming together, collaborating as a team, because no one discipline is going to be able to handle the load coming up.”

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