FEATURE STORY
Behavioral Health
Integrating Mental Health Into Primary Care
BY CASEY L . PENN
Mental health . While its importance has long been understood by physicians , it has become forefront in the national consciousness recently , in part due to the pandemic ’ s effects . An August 2022 article by Stacy Weiner for The Association of American Medical Colleges , 1 reports how mental health issues skyrocketed after COVID-19 . It reads , “ At the height of the pandemic , 40 % of adults reported symptoms of anxiety or depression — compared with 11 % pre-COVID . Over time , this dipped to 33 % in June 2022 , still higher than pre-pandemic levels .”
That rise has led to another concern already on medical radar screens : the shortage of mental health professionals . Weiner reports , “ Regardless of the great need the U . S . has too few mental health professionals … within a few years , the country will be short between 14,280 and 31,109 psychiatrists , psychologists , social workers , and others will be overextended as well .”
Weiner ’ s article is one of many highlighting a mental health crisis and sharing efforts by leaders to find solutions . “ Some are using telemedicine to meet patients wherever they are ,” she wrote . “ Others focus on recruiting and training a fresh crop of psychiatrists . And still others aim to educate and support primary care providers ( PCPs ), the frontline physicians who treat most mental health patients .
Such a collaborative , interprofessional approach is crucial in filling the psychiatry gap .”
Seeking to understand the climate of a “ collaborative , interprofessional approach ” to the mental health needs of patients here in our state – particularly from a primary-care perspective – The Journal reached out to Arkansas physicians who have experienced this approach and to one of the experts they ’ ve turned to for help .
A local physician heavily consulted in this approach , Patty Gibson , MD , is board certified in psychiatry , addiction medicine , and anesthesiology . She has extensive knowledge and experience assisting family medicine , internal medicine , and other primary care physicians in integrating behavioral health into their practices .
Dr . Gibson is currently a psychiatric consultant for Arkansas Health Group / Baptist Health System , an adjunct clinical assistant professor of Psychiatry at UAMS , an instructor for The REACH Institute ( thereachinstitute . org ), and a co-founder and chief medical officer of the Arkansas
Behavioral Health Integration Network ( ABHIN ). Formerly , she was medical director for Baptist Health ’ s Behavioral Health Integration Network and later worked for Alleviant Health as chief medical officer . She first became immersed in a working behavioral health integration system while working at the Veteran ’ s Administration .
Her expertise affords unique insights into behavioral health integration as a solution to our mental health crisis . “ We know there aren ’ t enough mental health providers ,” she began . “ Of those who get referred to mental health by their PCPs – 80 % never make it to a mental health appointment . Aside from associated fear , stigma , etc ., they must find someone that takes their insurance , and then they may wait several weeks to see a counselor and several months to see a psychiatrist . Research shows that when people need this help and don ’ t get it , it leads to their having trouble keeping and succeeding at jobs , using drugs , getting put in jail , and other consequences .”
Dr . Gibson confirmed that most mental health care is already being done by PCPs . “ The problem is many don ’ t have the training to feel comfortable with it ,” she said . “ Many need more education in best practices to screen patients for mental health issues and develop a plan for their patients . Part of the solution for PCPs can be building relationships with mental
38 THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY