Reprinted from the Health District's quarterly publication mailed to district residents (Fall 2005)

For some local residents, getting help for mental health or substance abuse problems is now as easy as visiting the family doctor.

The improved access to services is the result of a new Health District program that has increased the number of mental health professionals at two local clinics that see a large percentage of uninsured and low-income patients.

Medical providers and mental health specialists there work side-by-side, learning from each other as they seek the most effective and efficient treatment for their patients.

This groundbreaking effort is officially called the Integration of Mental Health and Substance Abuse Services into Primary Care Program, but is often known simply as the Integrated Care Program. Its centerpiece is a team consisting of a psychiatrist and four therapist/case managers, two of whom have specialized training and certification in treating people with drug or alcohol problems. Rounding out the team is an administrative assistant, with a psychologist soon to be hired.

Team members divide their time between Salud Family Health Center and Family Medicine Center, seeing patients whose initial complaints may be physical in nature, but who often have mental health problems – like mild depression or anxiety.

Frequently, a patient’s situation is complicated by alcohol or drug use or by chronic illnesses like diabetes or heart disease.

“The people we are seeing have incredibly complex psychosocial issues in their lives  – divorce, abuse, homelessness, substance use,” says Laura Schwartz, one of the therapist/case managers with the new program.

One thing they usually don’t have is insurance coverage for mental healthcare or easy access to services. That’s especially true of people with severe mental health problems – like bipolar disorder or schizophrenia – who are showing up at the two clinics in increasing numbers.

“We’re seeing more and more severe mental health issues in patients, including those who’ve had psychiatric care and were cut off from services,” says Dr. Carol Pfaffly, director of behavioral medicine at Family Medicine Center.

Potential problems sometimes are identified through a written survey filled out by patients before their healthcare provider sees them. Or providers may suspect mental health or substance abuse issues are involved and call for a consultation by the team’s psychiatrist, Dr. Richard Oddy.

Subsequent treatment options vary, but could range from intensive ongoing care by Dr. Oddy, to a one-time counseling session with one of the therapist/case managers. Most important, say all involved, is that patients have the opportunity to begin their road to recovery immediately, without needless delays or additional barriers to care.

“It is so much more effective for patients to have both their physical and emotional needs addressed quickly and efficiently in one place,” Schwartz  says, and in a place where they are most comfortable seeking care  – their doctor’s office.

Although medical and mental health teams meet weekly to discuss cases in detail, having both groups of providers working together under one roof also makes it easier for “hallway consultation,” says Dr. Oddy. In fact, this close working arrangement benefits primary care providers as well as their patients.

“Providers become more confident and skilled at managing mental illness and substance abuse in their practice and better at referring patients for appropriate treatment,” Dr. Oddy says.

These educational benefits assume even more significance at Family Medicine Center, a clinic operated by Poudre Valley Health System that provides experience to family practice residents.

As a result of the new partnership, Dr. Pfaffly says, a new generation of physicians is developing new skills for improving the doctor-patient relationship.

And that’s good news for the next generation of patients who may find that both physical and emotional healing can begin with a visit to their primary care provider.