Louisville Medicine Volume 69, Issue 8 - Page 12

AUTHOR Nardin Michaels , PsyD
FEATURE

THE HEAD AND THE HEART : A WINNING COMBINATION

AUTHOR Nardin Michaels , PsyD

Mental illness is among the most common health concerns in the U . S ., with an estimated 20 % of American adults affected ( NIH , 2019 ). Mental Health America ( 2022 ) reports troubling rates surrounding the impacts of mental illness and unmet treatment needs . The prevalence of American adults who report experiencing serious thoughts of suicide has continued to rise steadily since 2011 and is presently estimated to be 4.58 %. Yet another alarming and consistently rising trend is reflected in the lack of access to mental health treatment , with nearly a quarter of all adults with a mental illness reporting barriers that prevent them from accessing it . Barriers to treatment access and care are ubiquitous and often include lack of insurance or limited coverage of behavioral health services , a shortage of specialty practitioners or specialty services , lack of both provider and patient knowledge regarding treatment options and resources , financial burden , and the persistent stigma around the topic of mental health . Additionally , the shortage of providers and consequent demand placed elsewhere on health care systems can lead to administrative gaps which compromise continuity of care and referral follow ups .

Specialist shortages within the health care system place a unique burden on primary care physicians and staff , many of whom are already managing increasingly heavier workloads and higher patient volumes . Additionally , patients may lack adequate knowledge of mental health treatment options and resources for care , increasing the likelihood of the primary care physician as the first point of contact for individuals presenting with behavioral health needs . With a link between mental and physical health already well established , research indicates high rates of medical and psychological comorbidities in primary care patient populations ( Baumeister & Hutter , 2012 ). Research findings also indicate that psychotherapy , as part of early mental health treatment , can reduce overall medical utilization and expenses ( APA , 2012 ). In fact , one study found that patients diagnosed with a mental health disorder that underwent treatment saw an overall reduction in their medical costs while those without treatment saw an increase in their medical care costs ( Chiles , Lambert , & Hatch , 2002 ). Primary care practitioners play a vital role in the diagnosis and treatment of mental and behavioral health conditions . While some behavioral health problems , such as depression or anxiety , can be easily managed in a primary care setting , others , such as substance abuse or severe mental illness , will require referrals to specialty care . Psychotherapy can be useful for a wide range of difficulties including daily life stressors , trauma , adjustments to medical illness or other health problems , grief and
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