Surgeon General's 2000 Report: Integration of Mental Health Services and Primary Health Care provides a set of twelve core principles to facilitate the development and implementation of national and local programs. They include an emphasis on consumers and their families, promotion of health and overcoming disparities, basic characteristics, financial incentives for team approaches, reimbursement to support evidence-based care, collaboration/collocation, chronic illness and continuity of care, standardized quality and outcome measures, building on existing models, research and demonstrations, investment in training, and information technology 10 .
Call to Action
Mental Health America is dedicated to supporting national, state, and local efforts to integrate mental and general health care and to continued efforts to improve the quality of mental health and substance use services available in general health care settings and the quality of primary health care services available in specialty mental health care settings. Our goal is to foster the broad implementation of available research and models in real-world health delivery systems, to ensure that services are appropriate to the population being served, and to eliminate the clinical, financial, policy and organizational barriers to the integration of mental and general health care.
- The integration of mental and general health care must occur at all system levels including the federal, state, and local levels. It also requires a clear effort to overcome the clinical, financial, policy and organizational barriers to fully integrating mental and general health care.
- Many effective mental health services, especially psycho-social, recovery-oriented and rehabilitation services have not been provided in traditional medical treatment settings. It is essential that such services be provided as components of integrated treatment of mental health conditions.
- The federal government should clarify the ability of primary care providers to bill for mental health services, including prevention, screening, and consultation. Medicaid should financially support care coordination and other integration models that have proven to be effective at addressing the needs of diverse populations.
- The federal government should build integration into grant programs, information technology, and policies. The private sector should share its experience with care coordination in order to help foster the growth of integration in all health systems.
- There should be a national action agenda established to foster relationships between consumers, providers, physicians, and payers to overcome the barriers that prevent broader utilization of integration models.
- States and local authorities should also develop initiatives to oversee the provision of health care and to develop community coalitions that can implement integration models that address their communities' unique needs.
- Information technology has the potential to improve the delivery of comprehensive services through improved communication and coordination. The coordination of information systems that bridge systems should promote the use of shared databases across all health service areas while maintaining patient/consumer rights and privacy. Integration also requires better coordination of quality outcome/performance measures. If the quality metrics used to measure healthcare are not aligned, efforts to establish best practices in integration will be pointless. Measurement standards should cross mental and general health and should be influenced by consumer preferences and input.
- As Health Information Exchanges are established, states should assure the maintenance of strong privacy and consent policies concerning mental health and substance abuse conditions along with those concerning the treatment of minors. Technological and policy solutions should be developed so that these important protections do not prevent or inhibit the exchange of electronic health records between general health and behavioral healthcare providers in order to