“One-stop shopping” is viewed as a good thing when it comes to buying groceries, picking up a prescription, grabbing a cup of coffee and filling your gas tank.
Why not do the same when it comes to physical and mental health care? This concept is the focus of the American Counseling Association’s Interest Network for Integrated Care.
One of ACA’s 17 interest networks, the group’s members exchange ideas, advocate for integrated care and discuss current challenges in the field, such as the complications of insurance billing and reimbursement.
Integrating mental and medical health care is a trend in the United States and beneficial to both practitioners and clients/patients, says network co-leader Russ Curtis.
Patients/clients are usually much more comfortable – and more likely to continue treatment – if mental health care is offered from the same office or network as their primary care physician, says Curtis. Therefore, counselors need to know how to work collaboratively and effectively with primary care medical offices.
Curtis, a licensed professional counselor and associate professor in the counseling program at Western Carolina University, co-facilitates the integrated care interest network with Teresa Jacobson, the network’s founder who is working on a doctorate in behavioral health from Arizona State University.
Integrated care Q+AAnswers submitted by Russ Curtis, co-facilitator of ACA’s Interest Network for Integrated Care
Why should counselors be aware of/interested in integrated care?
First, many counselors will work with clients who are taking medication and/or have comorbid medical conditions, making it imperative for counselors to know how to consult with medical professionals.
Second, the research is clear that clients prefer to receive their mental health care within their primary care providers’ offices. This type of one-stop shopping ensures better coordination of total health care and reduces the stigma many clients feel when having to go to a mental health center. As such, counselors need to know how to work effectively within primary care medical offices.
What are some current issues or hot topics that the network has been discussing?
The inability of LPCs to bill Medicare is a pressing concern which requires constant and creative legislative lobbying.
Another concern is that in some states (i.e., North Carolina, Ohio), LPCs cannot perform Evaluations for Commitment, which, in addition to the Medicare issue, can keep LPCs from working within medical practices and hospitals.
What challenges do counselors face in this area?
The inability to bill Medicare can keep LPCs from getting hired within medical practices and hospitals.
What’s going on in this area? Any new therapies, legislation, etc.?
Legislatively, all counselors need to call their senators and ask them to support the Seniors Mental Health Access Act [that would allow] LPCs to bill Medicare.
What are some trends you’re seeing?
In the early 1990s when I was working in a mental health center, the substance abuse treatment facility was located 5 miles from our center and refused to see our clients. Now it is accepted practice that you must integrate substance abuse and mental health treatment. Not that we will do away with “focused” substance abuse treatment centers, but health care professionals now know we must tend to the total care of clients.
Now, integrating mental with medical health care is a huge trend in the United States and already a staple in many developed countries where socialized medicine is practiced. In an interview [that ran in the June 2012 issue of Counseling Today], Kathleen Sebelius, the secretary of the U.S. Department of Health and Human Services, mentions the importance of integrating care to increase the quality of care while decreasing costs.
What does a new counselor need to know about this topic?
New counselors need to know how to consult with medical professionals. They need to be able to perform brief assessment and provide brief therapy. New counselors need to learn as much as possible about psychotropic medicines, including their side effects, so they can help monitor and distinguish between symptoms and side effects. This type of knowledge and care is valuable to both client and physician.
What does a more experienced counselor need to know?
[They should] continue to build and hone their assessment, treatment and collaboration skills. They must also monitor the effectiveness of the services they are providing.
What are some tips or insights regarding this area that could be useful to all counselor practitioners?
As mentioned above, build assessment and treatment skills, and set up a system where the effectiveness of services provided can be monitored. I’d recommend that all integrated care counselors collaborate with university researchers to best monitor key client variables.
What makes you personally interested in this area?
The separation of mental and medical health care is insane. As such, more and more health care professionals and policymakers recognize the effectiveness of integrating care. I’m interested in this for two primary reasons: 1) clients who are not receiving integrated care are not receiving total care and that is causing much undo stress and frustration, which then, 2) costs this country a ludicrous amount of money in wasted medical tests and procedures. The separation of mental and medical health care truly baffles me.
The Interest Network for Integrated Care is one of 17 interest networks open to ACA members. In the coming months, CT Online plans to highlight each network – from sports counseling to traumatology – with an online Q+A article.
For more information on ACA’s interest networks or to get involved, see counseling.org/aca-community/aca-groups/interest-networks.
For more on integrated care:
Listen to ACA’s podcast with Russ Curtis and Eric Christian: counseling.org/knowledge-center/podcasts/docs/aca-podcasts/ht030-integrated-care-applying-theory-to-practice
Bethany Bray is a staff writer at Counseling Today. Contact her at firstname.lastname@example.org.
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