Health Care Reform: Integrated Health Care

Integrated health care, often referred to as interdisciplinary health care, is an approach characterized by a high degree of collaboration and communication among health professionals. What makes integrated health care unique is the sharing of information among team members related to patient care and the establishment of a comprehensive treatment plan to address the biological, psychological, and social needs of the patient. The interdisciplinary health care team includes a diverse group of members (e.g., physicians, psychologists, social workers, and occupational and physical therapists), depending on the needs of the patient.

The benefits of an integrated health care approach extend to patients, caregivers, providers, and the larger health care system. For instance, research indicates that integrated health care is effective in reducing depressive symptoms. Further evidence suggests that coordinated care, which integrates psychologists and other mental health providers within primary care, can enhance access to services, improve quality of care, and lower overall health care expenditures.

Integrated health care delivery can occur in multiple settings to benefit individuals across the lifespan. These settings include: primary care, specialized medical settings (e.g., rehabilitation units, cardiology, and surgical centers), long-term care settings, and community-based health and social service sites. The integrated health care team often functions differently according to the setting. However, mutual respect and communication are critical at all sites.

• Conduct cognitive, capacity, diagnostic, and personality assessments that differentiate normal processes from pathology, side effects of medications, adjustment reactions, or combinations of these problems. 

• Offer behavioral health assessment and treatment that provide individuals with the skills necessary to effectively manage their chronic conditions. 

• Diagnose and treat mental and behavioral health problems (e.g., depression, suicide risk, anxiety disorders, addiction, and insomnia). 

• Offer consultation and recommendations to family members, significant others, and other health care providers. 

• Contribute research expertise to the design, implementation, and evaluation of team care and patient outcomes. 

• Develop interventions that are responsive to specific individual and community characteristics that may impact the treatment plan.

APA RECOMMENDATION: Integrate mental and behavioral health care into primary care and other health care services for persons across the lifespan, with psychologists recognized as vital members of interdisciplinary health care teams.
 
Specifically, attention should be directed to:

• Establish new and support existing programs to make mental and behavioral health services an integral part of care in primary care and other health care services, including: 

  • The Positive Aging Act, which would make mental health services for older adults an integral part of primary care services in community settings and extend them to other settings where older adults reside and receive services; 

  • The National Health Service Corps and Federally Qualified Health Centers provide essential integrated health care services (including mental and behavioral health) to underserved populations; 

  • The role of psychologists and non-physician providers in the medical home model, which should be more appropriately named the “health home model;” and

  • Payment and other incentives to promote provider primary care collaboration and accountability to all providers, not just physicians.

• Support and expand interdisciplinary training opportunities for psychologists and other health care professionals under Title VII of the Public Health Service Act, including:

  • The Graduate Psychology Education (GPE) Program, which provides grants to accredited psychology doctoral, internship, and postdoctoral training programs to support the interdisciplinary training of psychology graduate students.

• Support funding for scientific research related to the impact and effectiveness of integrated health care and the contributions of psychologists as members of these teams.

• Support funding for scientific research related to factors of diversity (e.g., age, race and ethnicity, gender, sexual orientation, disability, socioeconomic status, family structure, culture, and immigration status) affecting access to and use of integrated health care services.

Adapted from the APA Blueprint For Change: Achieving Integrated Health Care for an Aging Population.