s, 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 integrate care and prevent medical errors.
- The federal government and states should expand incentives for behavioral health providers to reach Health Information Technology Meaningful Use standards so consumers/patients of these providers can receive integrated care. Organizational issues that need to be addressed include training on both sides of the integration interface: Healthcare workers need to be educated on the value of addressing all health needs in an integrated way, on the recognition of health conditions, and on how to treat mental conditions and when and how to refer to community services.
- It should be an overarching goal to reduce the stigma within both provider communities to eliminate the separation of mental and general health and to overcome stereotypes about individuals with mental health conditions.
- A first step should be better utilization of screening tools in primary care settings with tools that are culturally competent and appropriate for varying literacy levels.
- Evidence-based practices should be expected regardless of the care-setting. Providers should be held accountable for the off-label use of psychotropic medications with children and any overuse of these medications for behavioral management in institutional settings like nursing homes for the elderly.
- Research is needed on the use of integration models with various mental health conditions and for addressing the needs of disparate populations and co-morbidities.
This policy was approved by the Mental Health America Board of Directors on June 9, 2012. It is reviewed as required by the MHA Public Policy Committee. Expiration: December 31, 2017
- IOM, Improving the Quality of Health Care for Mental and Substance-Use Conditions, Quality Chasm Series. Washington: National Academies Press, 2005.http://www.iom.edu/?id=30858
- CDC, The Role of Public Health in Mental Health Promotion, September 2, 2005 / 54(34); 841-842.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a1.htm
- See MHA Policy Statement P16 - The Health and Wellnes