By Dr. Richard Juman, PsyD, TeamHealth National Director of Psychological Services
Clinicians and healthcare organizations that recognize the impact of mental health conditions on their patient outcomes will thrive, and that finding is magnified when the treatment of behavioral and physical health is done in an integrated manner, which improves outcomes for both medical and psychiatric disorders. In a value-based healthcare environment, clinicians and organizations that ignore the profoundly negative impact that mental health conditions have on patient outcomes are fighting an uphill battle. Here’s why, and how:
- Mental health disorders are prevalent. The World Health Organization reports that depression is the “single largest contributor to global disability” with anxiety disorders not far behind. In the United States, we’re struggling with simultaneous epidemics of opioid overdose and suicide. In fact, U.S. life expectancy just went down for the first time since World War I, when the war and a flu pandemic took their toll. The current decrease, shocking in the world’s most affluent nation, is significantly fueled by the opioid epidemic and suicide, where depression is obviously the key factor.
- Physical and mental illness are intertwined. Psychiatric conditions can cause, or exacerbate, medical conditions; medical conditions can cause, or exacerbate, psychiatric conditions. Additionally, psychiatric conditions can present as medical conditions, and vice versa. Treating either half of such a complex and dynamic system doesn’t make sense, nor does treating them separately, but that is historically the way that we’ve operated, with a medical system and a mental health system working physically and ideologically apart from each other.
- Mental disorders have a huge impact on medical outcomes. One of the reasons that psychiatric illness is so costly, when examined from either a population health or a financial standpoint, is that it is much more difficult to achieve good medical outcomes in patients with co-occurring psychiatric disorders. A well-known example of this phenomenon is that the life expectancy of people with chronic and significant mental illness can be more that 20 years less than the rest of the population. But in the general medical population, common mental disorders such as depression have extremely deleterious impacts on the cost of treating common medical conditions such as cancer, heart disease and diabetes. Treating patients with these conditions that are also depressed can cost two or three times more than it would cost to treat non-depressed patients with the same conditions—an “uphill battle” indeed in a value-based world.
- Treating mental disorders improves medical outcomes and reduces overall cost. “Cost offset” refers to the concept in which performing an action in one domain results in cost savings in another. A robust meta-analysis of the cost offset realized through the provision of psychiatric and psychological services finds that the average savings that result when such services are provided is around 20%. What else can a clinician, or a medical services company, do that will result in comparable improvements in the patient outcomes and cost-efficiency that are the focus of value-based models?
- Medical clinicians benefit too. While patients clearly benefit when their mental health needs are appropriately addressed, medical clinicians are winners as well. Integrated behavioral health leads to improved patient education, compliance and communication and both medical and behavioral health clinicians working in integrated models report improved satisfaction with their work.
May is Mental Health Awareness Month, so it’s a good time to sharpen our focus around psychiatric issues in the patients that we treat. It’s also a good time to take stock of our own mental health needs, and make sure that we are at our best—both mentally and physically!
As a part of TeamHealth’s commitment to physical and mental well-being, we invest in programs to aid in clinician wellness. In 2016, we enhanced available wellness resources through our LiveWell WorkLife Services to help colleagues combat personal challenges—burnout, depression, anxiety, financial and legal issues and more. For more information on this program visit our LiveWell WorkLife Services page, or contact firstname.lastname@example.org.
Are you passionate about mental health? Join a nationwide network of world-class clinicians, mentors and industry thought leaders all working to provide integrated behavioral and physical healthcare. TeamHealth has open opportunities for you to make an impact!