The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward. The book's features are both high-impact and user-friendly: The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.

This text provides new clinicians with an overview of the tasks involved in behavioral health treatment as it is practiced in community-based training organizations. The text’s specific focus is on the application of theoretical and academic knowledge to clinical work as a psychotherapist or case manager, with a case example that follows treatment from the first session through termination. It contains an overview of all aspects of treatment that are required in these organizations, which are the primary settings for practicum, internship, and post-graduate training.

Integrated Care: A Guide for Effective Implementation provides a detailed, thoughtful, and experience-based guide to the complex and potentially overwhelming process of implementing an integrated care program. The advantages of integrated care from both the clinical and administrative perspectives are many, including better detection of illness, improvement in overall health outcomes, a better patient care experience, flexibility in responding to policy and financial changes, and an emphasis on return on investment. The book addresses the emerging framework of core principles for effective integrated care, reviews the most up-to-date research on implementation, and presents practice-based experience to serve as a guide. This information is useful in both traditional integration of behavioral health into general medical settings (often primary care) or integrating general medical care into a specialty mental health or substance use treatment setting. Because administrators, clinicians, policy makers, payers and others need guidance in determining what effective implementation looks like, the authors offer a three-part examination of the key components of an implementation strategy and explore the elements essential for success. The book is grounded in the authors' real-world expertise and offers readers practical, accessible information and support: Often efforts to implement an integrated care program fail because the model is more than just "plug and play." To address this misconception, the authors explore the successful implementation from every angle -- from leadership, primary care, therapist, psychiatric provider, and policy perspectives. As procedural and institutional hurdles are being overcome, codes for integrated care have been adopted. Accordingly, the book provides in-depth coverage of finance and funding models, challenges to billing, and emerging payment models. Each of the chapter authors were selected for their direct clinical experience in various integrated environments, their leadership in ushering teams through these initiatives, and/or their deep knowledge of payment and policy barriers. Impediments to the widespread implementation of evidence-based programs include payment and regulatory barriers, lack of a workforce trained in effective collaboration, and cultural differences between the worlds of primary care and behavioral health care. Integrated Care: A Guide for Effective Implementation helps health care leaders and providers overcome these obstacles to implement a successful, patient-centered integrated care program.

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

A bold, expert, and actionable map for the re-invention of America’s broken mental health care system. “Healing is truly one of the best books ever written about mental illness, and I think I’ve read them all." —Pete Earley, author of Crazy As director of the National Institute of Mental Health, Dr. Thomas Insel was giving a presentation when the father of a boy with schizophrenia yelled from the back of the room, “Our house is on fire and you’re telling me about the chemistry of the paint! What are you doing to put out the fire?” Dr. Insel knew in his heart that the answer was not nearly enough. The gargantuan American mental health industry was not healing millions who were desperately in need. He left his position atop the mental health research world to investigate all that was broken—and what a better path to mental health might look like. In the United States, we have treatments that work, but our system fails at every stage to deliver care well. Even before COVID, mental illness was claiming a life every eleven minutes by suicide. Quality of care varies widely, and much of the field lacks accountability. We focus on drug therapies for symptom reduction rather than on plans for long-term recovery. Care is often unaffordable and unavailable, particularly for those who need it most and are homeless or incarcerated. Where was the justice for the millions of Americans suffering from mental illness? Who was helping their families? But Dr. Insel also found that we do have approaches that work, both in the U.S. and globally. Mental illnesses are medical problems, but he discovers that the cures for the crisis are not just medical, but social. This path to healing, built upon what he calls the three Ps (people, place, and purpose), is more straightforward than we might imagine. Dr. Insel offers a comprehensive plan for our failing system and for families trying to discern the way forward. The fruit of a lifetime of expertise and a global quest for answers, Healing is a hopeful, actionable account and achievable vision for us all in this time of mental health crisis.