Psychologists and Integrated Primary Health Care

“Primary care integrates physical, psychological, and social aspects of health and emphasizes both the care of the patient as an individual and as a member of a larger community. Primary care providers must analyze and logically employ newly developed screening and diagnostic tests, emphasize patient education, health promotion, and disease prevention and management. Comprehensive care requires the talents of many health professionals including physicians, nurse practitioners, physician assistants, nurses, [psychologists], and others. Specialized populations such as older adults have an even greater need for integrated health care.” PEW Health Commission, 2005

As America’s evolving health care system seeks to integrate the physical, social, and psychological aspects of health care, it is imperative that interdisciplinary health care which include psychological services is at the core of that system. Interdisciplinary health care offers better, more cost-effective and timely treatment than do traditional primary health care services.

According to one study, seventy percent of all primary care visits are driven by psychological factors patients with mental and behavioral health problems flood general practitioners’ offices with such symptoms as generalized anxiety, panic, depression, and stress, physicians are increasingly pressured to diagnose and treat problems they have not been adequately trained to diagnose or treat.

Patients who seek treatment from an interdisciplinary team that includes physicians, (nurses, or physician assistants) and psychologists are at less risk of misdiagnoses, receive more effective treatment, and decrease their health care costs.

Interdisciplinary teams provides patients with the advantages of a wider, more diverse professional skill set, the integration of ideas, and a more robust set of intervention strategies.

An Integrated Health Care Model for Older Adults

"Blueprint for Change: Achieving Integrated Health Care for an Aging Population" (February 2008) developed by the American Psychological Association (APA) Presidential Task Force on Integrated Health Care for an Aging Population proposes a basic model for interdisciplinary health care that includes many health care providers, with the specific professions represented on any team varying according to the needs of patients served.

In an interdisciplinary team, no one person is designated as "the leader," although one person might function as an administrative "coordinator." Such teams "are characterized by shared leadership and shared power in decision making across all the professions involved in the team," the task force wrote, adding that “such teams have long been used by the Department of Veterans Affairs, as well as in many long-term care settings and in many geriatric primary care sites.”

The knowledge and skills that psychologists contribute to integrated health care include an understanding of aging and adult development and the ability to clarify which clinical problems might be reversible, such as those caused by other treatments or medications. Psychologists can also assess mood or anxiety disorders, psychosis and suicidal symptoms, among other mental health issues. Psychologists also can address behavioral medicine issues, such as insomnia, pain or difficulties adhering to medical treatment. The report specifically notes that the contributions of geropsychologists, health psychologists, neuropsychologists and others trained in behavioral medicine "will be particularly welcomed among integrated health care teams."