The Value of Integrated Care

During the past decade, healthcare professionals and organizations have begun to recognize the value of addressing their patients’ physical and mental health needs in one location. Many family medicine offices now offer therapy and/or medication management with a professional counselor, psychiatric nurse practitioner or even a psychiatrist. Specialty practices are also making it easier for their patients to receive mental health treatment in the same place that they receive cancer, cardiac or other specialty care.

Patient benefits from this integration include accessibility, convenience, compliance and better outcomes as discussed by five Centra providers as follows.

The mind/body connection

Bailey Evans Licensed Professional Counselor Bridges Treatment Center

The brain and body have a significant and important connection. The body sends the brain signals in order to influence decision making and the brain sends the body signals to respond. When a person experiences a stressor, it is a natural and normal response for the parasympathetic nervous system to get triggered. When this happens, the heart beats faster and breathing becomes more shallow and rapid. Adrenaline and cortisol are released in the brain, and the body prepares to give a response such as to run away (flight), fight or freeze. These responses are meant to protect us and to keep us alive.

Interestingly, there are medical conditions that create similar body responses such as heart rate increase and rapid and shallow breathing. It is not unusual for the brain to become confused by these symptoms and create a low level of anxiety for a person. As the body works to communicate its experience to the brain, the brain is also working to make sense of the body’s experience.

For example, when a person receives a diagnosis of a chronic, serious, and possible terminal disease, such as multiple sclerosis or cancer, it is well documented that there is a high correlation of signs and symptoms of anxiety and depression. This reaction may be due in part to the activation of the cycle of grief. Ultimately, one must grieve the loss of the future they believed they would have, the way their body would function, and come to some acceptance of his or her situation. Seeking help for the emotional distress associated with chronic illness is crucial to healing the body and the mind.

Michele Donoghue Certified Family Nurse Practitioner Centra Farmville Medical Center

In my eight years as a primary care provider, I have found that patients in rural areas in need of mental health evaluation and treatment see their primary care provider first. In my practice, I often hear “why do I feel this way?” Or more troubling, “I know I need help, but I cannot find anyone who knows how to help me.” I see a comparable number of patients for mental health issues as I do for diabetes.

Mental instability has a significant impact on every aspect of a patient’s health and well-being, so it is imperative to integrate mental health care into the primary care setting. This integration can help promote adherence to mental health treatment by mitigating the negative effects of social stigma associated with mental illness. It is crucial that primary care providers, like myself, collaborate with mental health providers to promote optimal outcomes for our patients.

Maria Almond, MD Adult Psychiatrist CMGroup Piedmont Psychiatric Center at Farmville Medical Center

When I was opening my psychiatric practice two years ago, I learned that a new primary care center under Centra leadership was in the works. I knew right away that I wanted to be there working with primary care providers whose patients often present with mental health issues.

Being embedded in the center allows me to be part of the primary care team. It automatically signals to our patients that we are practicing whole person medicine—mind and body. For our patients, this means that mental health care is just a step away in a familiar place. We begin to decrease stigma when we treat mental health disease just like any other illness.

Lakshman Gandham, MD Psychiatrist CMG Piedmont Psychiatric Center

Last year, I began providing psychiatric evaluations for individualswho would potentially undergo bariatric surgeryfor weight reduction. Obesity is a medical condition thathas multifactorial etiology. In some patients, emotionaland psychological factors play a major role in behavioralpatterns around their eating habits and distorted perceptionsabout food.

My role is to assess individuals at the Centra Weight Loss Clinic for any underlying mental health/emotional issues that can impact their ability to progress and follow through with lifestyle changes. I also assess whether substance use disorder may be a factor. I provide assessments two days a week with feedback sent to the treatment team. I also participate in team meetings to provide input about how best to help patients with psychological issues.

Chelsea St. Clair Licensed Clinical Social Worker CMGroup Piedmont Psychiatric Center Centra Stroobants Cardiovascular Center

Research has shown that immediate access to mental health services in outpatient clinics significantly reduces symptoms of anxiety and depression. As a provider for Centra Medical Group Piedmont Psychiatric Center, I am on site full-time at Centra Stroobants Heart Center and available for consultation with the heart specialists throughout the day. I also provide outpatient therapy in the same location when needed. The goal is to improve overall quality of life for our patients.