Epidemiologic trends and costs of fragmentation

Concurrent general medical and psychiatric illnesses frequently occur in the same individual, yet, are assessed and treated in health care systems worldwide as though a relationship between the two did not exist. This article reviews evidence about the negative impact that segregated behavioral health and medical business practices, care management, and clinician intervention have on clinical, functional, and financial outcomes. It discusses integrated care models that lead to health improvement and decrease the total cost of care. Finally, it delineates general steps that are needed to move from a fragmented to an integrated health system.