Health Care Reform and Integrated Care: A Golden Opportunity for Preventive Psychiatry

Abstract

The Affordable Care Act (ACA) includes provisions to shift the U.S. health care system to address achieving wellness rather than just treating illness. In this Open Forum, the Prevention Committee of the Group for the Advancement of Psychiatry describes opportunities created by the ACA for improving prevention of mental illnesses and promotion of mental health. These include improved coverage of preventive services, models to integrate primary and behavioral health care, and establishment of the National Prevention, Health Promotion, and Public Health Council, which has developed a National Prevention Strategy. The authors describe the important role that psychiatrists can play in advancing prevention of mental illnesses, in particular by working to incorporate prevention strategies in integrated care initiatives and by collaborating with primary care providers to screen for risk factors and promote mental and emotional well-being.

Mental health system in Saudi Arabia: an overview

“…13,14 However, high-income countries are also facing these barriers and challenges, and their MHSs are often reported to be failing 15,16. Most urgently, MHS reforms should include opening more clinics, updating existing clinics, changing public attitudes toward mental illness, educating the public regarding effective treatments, promoting wellness efforts to prevent mental health problems, integrating behavioral health care into primary health care (PHC), developing community mental health services, expanding access to mental health facilities, and generally raising standards for mental health care services 17,18…”

Disparities in the Use and Quality of Alcohol Treatment Services and Some Proposed Solutions to Narrow the Gap

“…To the extent that evidence-based alcohol screening and intervention is integrated into routine care at community health clinics, these settings hold promise for mitigating disparities in treatment access and quality. Funding provided to federally qualified community health centers through the Affordable Care Act (ACA) might be instrumental in this regard (64). Further, increased insurance coverage under the ACA might also reduce disparities in access to medically-based alcohol intervention.…”

Mental Health Collaborative Care and its Role in Primary Care Settings

“…Patient Protection and Affordable Care Act of 2010 (ACA) combine to present an opportunity to implement organizational and financial strategies to better integrate mental health care into primary care settings through CCMs [17-20]. Collaborative care is an underlying tenant in healthcare reform including two ACA mechanisms to control costs in complex patient populations: the patient centered medical home and accountable care organizations (ACOs) [8, 21, ••22, 23, 24-30]. As many aspects of ACA policy have yet to be finalized, mental health providers and PCPs have a vested stake in understanding current issues pertaining to mental health CCMs to better advocate for policies that can promote the uptake of this model to help achieve the triple aim of improving health and quality of care in a cost-efficient manner [17, 31].…”

“…To achieve this end, we conducted a rigorous search of Pubmed® to identify relevant English-language articles published between January 2012 and March 2013 that included empirically-based research studies, topical reviews, influential commentaries, and guideline/consensus statements focused on collaborative care for mental health in adult patient populations. Key words utilized in the search included: “primary care”, “general medicine”, “collaborative care”, “integrative care”, “chronic care model”, “patient-centered medical home”, “medical home” “treatment model”, “mental health”, “mental health disorders” “mood disorders”, “anxiety disorders”, “depression”, “bipolar disorder”, “substance abuse disorder”, “addiction disorder”, “serious mental illness”, and “behavioral medicine.” A total of 74 articles were identified for inclusion in this review of the literature [5-10, 13, ••14, ••15, 16-21, •22, 23, 24, 26, 27, 29, 30, 32-36, ••37, 38-40, •41, •42, 43-47, ••48, 49-53, ••54, 55-68, •69, 70-83]. …”