Reunited the Inseparable: A Case Study of the Practices Employed by Patient Centered Medical Homes to Address the Mental Health of Adult Patients

Mental and physical health are inseparable but care has not been, treated by two distinct professional systems. The purpose of this capstone project is to review the practices employed by patient centered medical homes (PCMHs) to identify and find treatment for depression and anxiety in routine care to more effectively treat mental illnesses. Mental illness led to 300 billion dollars in lost productivity in 2002. According to the CDC, anxiety and mood disorders are the most common mental illnesses in this country. In the US a large percentage of adults seek help for mental health conditions from their primary care provider. PCMHs represent a growing area of primary care, which aims to provide whole person care. In the area of mental health this means changing the way that primary care providers and behavioral health providers coordinate patient care. Representatives from five PCMHs in Fairfield, County, Connecticut were convenience sampled for interviews. All five of the practices interviewed use the patient health questionnaire (PHQ) 2 and 9 to screen patients for depression. None used a specific screening tool for anxiety. Three of the practices used enhanced referral systems to connect patients with care. The remaining two practices have co-located integrated behavioral health care providers. The representatives of sites using referral based care treatment sited issues with provider communication, trouble navigating legal constraints on provider communication and adding behavioral health care providers to existing primary care practices. Representatives of the co-located sites spoke on the trial and error nature of adding behavioral health care to meet patient needs. All the practices interviewed were dedicated to providing whole person care. The interviews highlighted a need for greater communication and coordination of efforts to build mental health care coordination at PCMHs. Just as individuals do not have to treat mental health issues alone, practices do not have to build infrastructure to better treat these issues alone. Presentation: 15:5