Psychology is Primary Care

Psychology is Primary Care

People can reduce their risk of developing a major medical illness, receive more effective treatment, and reduce their health care costs when they seek treatment from an interdisciplinary team including behavioral and mental health care providers. Psychologists play an integral role in helping people modify their behavior to prevent and recover from health problems. American consumers and health care providers are better served when psychologists are included in primary care.

Psychological and physical aspects of health are interrelated

As much as 85% of physician visits are for problems that have a significant psychological and/or behavioral component such as chronic illnesses. For example, research has shown the connection between depression and osteoporosis and even cancer. (Stress Found to Weaken Resistance to Illness Washington Post, Dec. 22, 2003)

Seven of the ten leading causes of death (heart disease, cancer, stroke, chronic lower respiratory disease, accidents, diabetes and suicide) have a psychological and/or behavioral component. (CDC, 2005)

Poor diet and inactivity are surpassing smoking as the most avoidable cause of death. The other "deadly habits" are alcohol, motor vehicles, firearms and sexual behavior. (JAMA, 2004)

Psychological services in primary care increases quality of life.

Participation in group psychotherapy is associated with better psychological adjustment, treatment, and compliance for women with breast cancer (Blue Cross-Blue Shield & American Psychological Association Demonstration Project, 1998).

Malignant melanoma patients who participated in group psychotherapy shortly after their diagnosis showed more enhanced immunological functioning after six months than did a similar group of melanoma patients who did not engage in group psychotherapy (Fawzy, et al., 1993).

Pre-surgical psychological counseling is associated with fewer complications and a reduction in medication utilization (Belar, 1995).

Psychological interventions centered around positive health behaviors are associated with lower cholesterol levels and healthier blood pressure and body weight in elderly patients (Fries et al., 1993).

Psychologists design and implement interventions to help people manage their health. Interventions such as smoking cessation and stress management that can prevent the development of chronic diseases (Diekstra & Jansen, 1988).

The provision of psychological services to high frequency Medicaid users resulted in a 36% reduction in their Medicaid utilization after one year (Pallak, et al., 1995).

Hospitals that integrated psychology into primary care showed a 27% reduction in hospital admissions and bed days over a twelve-year period (Health Partners Study, 1997).

Many managed care companies treat the whole person in recognition that most psychological disorders can cause physical symptoms and vice versa. Mental health professionals must be located in primary (medical) care offices and collaborative treatment plans need to be developed. Defino, "Healing Body and Mind" HEALTHPLAN (Mar/Apr 1996)

Simply providing access to medical care that largely ignores the emerging evidence on psychosocial determinants of health, compromises the prospect of significantly improving the public's health. Sobel, Rethinking Medicine: Improving Health Outcomes with Cost-Effective Psychosocial Interventions, Psychomatic Medicine 57 (1995)

"In order to properly diagnose and manage patients with undifferentiated symptoms as well to improve the outcome for patients with known chronic disease, the traditional medical model must be replaced by a more integrated, comprehensive, biopsychosocial model of illness in which the mind and body are no longer seen as separate." (Epstein, Budd, & Cole, "Behavioral Disorders: An Unrecognized Epidemic with Implications for Providers" Behavioral Medicine Symposium (June, 1995)

Consumers value the role psychologists play in primary care.

Eighty-eight percent (88%) of the public, in a national survey, believe that mental health services should be available to everyone and that their health care system should treat the entire person including one’s mental well-being. (W.K. Kellogg Foundation, 1999).

Ninety percent (90%) of those surveyed believe that good psychological health plays a role in maintaining good physical health (Penn & Schoen poll, May 1995).

Interdisciplinary Primary Care promoted by PEW Health Professions Commission (January, 1995)

"Medical care in the merging environment of health care reform is driven by cost containment and management of services. Health care professionals working in collaboration can reach more patients at less cost and with a means of providing "seamless" coordinated care. The team approach allows providers to contribute from their individual areas of expertise, creates an environment for innovative care by bringing together different perspectives and problem-solving skills, and enables each patient to integrate the disparate aspects of his or her health care needs. The care provided to patients is forged by integration of ideas about patient needs and intervention strategies that would not be possible without the collective insight of an interdisciplinary team. A greater sense of completeness of care, a more stimulating practice and the shared management of very complex patients all add to a more effective clinical environment."