DIVISION REPORTS

Community and State Hospital

The author examines the idea that as the treatment of mental illness becomes more publicly recognized and financially reimbursable, there will be a need to provide more services in the context of integrated care

By Jim Regan, PhD

Hello all and season‘s greetings.

As many of you know, I have been inquiring throughout the country on the future role of psychology in public service. As we have seen, there is growing momentum to bring “mental health,” now more ubiquitously named “behavioral health,” into mainstream general medical care. A number of models have arisen throughout the country. These models range from bringing primary health care into behavioral health centers, having behavioral health as a specialty within a full range medical center and an emerging third model of the medical home. The first model is straight forward and has been in practice for some time. In this practice, primary care physicians would be assigned to a caseload of patients who were on the roles of say, a mental health clinic. This would help integrate services and assure good medical intervention. This model is still very prevalent. The second model however begins to create a possible shift in service provision that could portend to be a tipping point. Throughout the country there are now numerous, relatively large, integrated (to include mental health services) health care centers. As treatment of mental illness becomes more publicly recognized and financially reimbursable, there will be a need to provide services in the context of integrated care. It is no secret that large public state agencies (such as New York) have already started to view the future in a way that does not continue separate “systems” of care, but rather supports large integrated services. The third model, medical home, was developed some time ago as an approach to combine early treatment, and prevention by ensuring access. Recent reports from North Carolina indicate significant savings by implementing medical home concepts.

Where does all of this leave the public psychologist? What will become of the psychologist working in a public mental health clinic? What type of skills might be needed to work in a large integrated program? What should our graduate schools be teaching tomorrows’ practitioners?

I have had some good discussions on these issues. As I continue to gather more information, I will share my results, please feel free to email me.