Integrating Medical and Mental Health Care

I attended the 13th Collaborative Family Healthcare Association (CFHA) meeting in Philadelphia last week.  A prominent theme was difficulty gaining acceptance from medical clinicians about the role of mental/behavioral health practitioners in the primary care setting.  These practitioners provide skills helping people with complex medication regimens (insulin for example), weight management, smoking cessation, exercise regimens, substance abuse and stress management as well as help with mental health disorders.  But these resources are not used nearly as well as they could be.

In addition, the glaring blind spot in diagnosis and treatment of medically unexplained symptoms (MUS) persists.  Most MUS are due to PPD (psychophysiologic disorders or stress illness).  But as with most mental health professionals, many who attended the CFHA meeting lacked experience uncovering the psychosocial causes of MUS.

Fortunately, the CFHA has established an Interest Group for MUS and people who have decades of clinical and research experience have joined.  I am optimistic that this will lead to a half-day training session at a future meeting that will significantly improve skill levels in this area.  When medical clinicians learn that  their most frustrating patients (those with MUS) can benefit significantly from intervention by mental health practitioners, this will open the door to much greater acceptance of collaboration between these two groups on a wide range of clinical problems.

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