Speaking of Psychology: Better health through integrated care

Episode 7

 

As our nation strives to improve health outcomes for all Americans, APA and its Center for Psychology and Health are working to expand psychology’s role in health care by improving access to psychological and behavioral health services, particularly in primary care settings. In this episode, APA’s CEO Norman B. Anderson, PhD, discusses the importance of integrated health care teams and how they can help people live better lives.

About the expert: Norman B. Anderson, PhD

Norman B. Anderson, PhD Norman B. Anderson, PhD, is the chief executive officer of APA and director of its Center for Psychology and Health. Anderson is the former and founding associate director of the National Institutes of Health in charge of behavioral and social sciences research and was the first director of NIH's Office of Behavioral and Social Sciences Research. At NIH, he was charged with facilitating behavioral and social sciences research across all of the then-24 NIH institutions and centers. His research and writing on the effects of stress on biology and risk for hypertension have received several awards from scientific societies, including four honorary doctoral degrees. In 2012, Anderson was elected to the Institute of Medicine of the National Academies. Election to the IOM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service. Anderson is editor-in-chief of "The Encyclopedia of Health and Behavior" and author of a health book for lay audiences titled "Emotional Longevity: What Really Determines How Long You Live." He is also editor-in-chief of APA’s flagship journal, American Psychologist

Anderson earned master’s and doctoral degrees in clinical psychology from the University of North Carolina at Greensboro.

About the APA Center for Psychology and Health

The APA Center for Psychology and Health is dedicated to highlighting and advancing the contributions of psychology to the overall improvement of health status — both mental and physical — and health care in our nation. In so doing, psychologists aid in the prevention and treatment of serious and chronic illness (such as diabetes and heart disease) by focusing on modifying unhealthy behaviors, such as poor diet, inadequate exercise and substance use.

Transcript

Audrey Hamilton: Psychologists work to improve more than people’s mental health. Obesity, smoking, heart disease – all of these physical health problems often involve behavior. In this episode Dr. Norman Anderson, CEO of the American Psychological Association, explains how psychologists play an essential role on health care teams alongside physicians and other medical professionals. I’m Audrey Hamilton and this is “Speaking of Psychology.”

Today we are talking to Dr. Norman Anderson. Dr. Anderson is the CEO of the American Psychological Association and the director of the association’s Center for Psychology and Health.  As our nation strives to improve health outcomes for all Americans, the APA and its Center for Psychology and Health are working to expand psychology’s role in health by improving access to psychological and behavioral health services, particularly, in primary care settings. Welcome, Dr. Anderson. 

Norman Anderson: Thank you. Good to be here. 

Audrey Hamilton: Dr. Anderson, could you explain in more detail the reasons for creating the APA Center for Psychology and Health? 

Norman Anderson: Well, we have a strategic plan in APA and one of the goals in the strategic plan is to advance psychology’s role in improving the nation’s health. Most people understand that psychology and psychologists have a role in improving mental health – things like depression and anxiety – but, they don’t really understand that we have a very important contribution to make in improving overall health, even physical health. Our research has shown very clearly that behavioral and psychological factors contribute greatly to things like heart disease, the cost of cancer, HIV/AIDS, diabetes. So, we have a very important role to play in overall health, not just mental health. So the Center for Psychology and Health was created to really galvanize the resources we have within the central office to advance this overall goal in health. 

Audrey Hamilton: One of the goals of the Affordable Health Care Act is to have integrated health care teams. Can you tell us what those are and why they are important? 

Norman Anderson: Integrated health care teams are very important in improving the overall health of patients. Because we know that all health problems are multi-faceted – they involve biological factors, psychosocial factors, behavioral factors – it’s really important that you have the right mix of professionals working with patients on their health problems. For example, it’s important that physicians work hand-in-hand with psychologists or other mental health professionals, with nurses, with people from physical therapy, from a whole host of disciplines to really serve the whole patient and meet the whole patient’s health care needs. 

And research is beginning to show that when you do take this whole person approach to health, patient outcomes actually improve and there can be some cost savings. 

Audrey Hamilton: What kinds of behaviors are associated with disease? I mean, how exactly can a psychologist help treat disease? 

Norman Anderson: Well, in multiple ways. You know, for example, at the most basic level physicians are not really trained, unless they’re trained in psychiatry, to address mental health problems or to treat mental health problems. So, it’s very important that those mental health problems get addressed in primary care. You know, primary care is really on the frontlines of health care. So, it’s really important to have that mental health component available for patients right there within primary care. 

But, beyond mental health care, it’s very important that you have professionals, like psychologists, available to address health behaviors more generally. Things like diet, smoking, exercise, but also things like psychological stress, which is a major contributor to the course of illness. Essentially, behavioral and social factors contribute to health and illness across the whole continuum, from the initiation of diseases, for example, stress can actually change biology in ways to lead to a greater propensity to develop certain health problems. These same factors can be used to prevent health problems, such as helping a person develop more healthy lifestyle habits, such as quitting smoking, losing weight, can actually help prevent illnesses. But, also if a person has an illness like heart disease, certain factors like depression and stress can actually accelerate the course of their arteries secluding that is getting clogged and lead to a heart attack. So, throughout the whole continuum of illness, behavioral and social factors are important and they have to be addressed. 

Audrey Hamilton: What is on the 2014 agenda for the Center for Psychology and Health? 

Norman Anderson: Well, the center works in four primary areas. We work on advocacy, education and training of psychologists, communicating with our members and the public and outreach to other organizations. And so, we’ve got things planned in each of those areas. 

For example, with advocacy, we’re working to ensure that financing is available to help foster some of these integrated care teams that I spoke about earlier. Right now, we really don’t have good models to give the public access to these teams. So, we’re working with various organizations to help create those models. 

It’s also very important that we communicate with psychologists about the importance of learning about participating in integrated care teams and in primary care. Most psychologists, frankly, weren’t trained in this field. So we have to educate our own profession about the importance of this and provide training tools to help them get up to speed so they can participate as professionals. 

You know, one example of this is we have something called a briefing sheet series, which we are doing in collaboration with our interdivisional health care coalition. These are divisions of APA who are interested in health who have been really helpful to us in putting together fact sheets, briefing sheets that we call them on various aspects of health, such as psychologists working in primary care – psychologists working on the problem of chronic pain and obesity. So, this is sort of a first level of education for psychologists to get a brief, one-page overview of how psychologists contribute to preventing or treating some of these so called “physical health” problems. 

We also use those briefing sheets to help create content for our website, so they can be found there. And frankly, this type of podcast series, we will use those briefing sheets as a context to bring in psychologists who are experts in things like chronic pain to share that information with our members and the public, as well.   

Audrey Hamilton: Well, thank you Dr. Anderson for joining us. I appreciate it. 

Norman Anderson: My pleasure. Thank you.

Audrey Hamilton: For more information about the Center for Psychology and Health, please visit our website. With the American Psychological Association’s “Speaking of Psychology,” I’m Audrey Hamilton.