The integration of mental and physical health care is critical to improving health care. Government programs and private insurers can support integrated approaches in several ways. For example, primary care practices or clinics that have mental health practitioners either on-site (by far the best approach), or available to them in real time through electronic means, should be recognized and compensated for providing integrated care. Similarly, community psychiatric rehabilitation programs or community mental health centers serving people with serious mental illness should receive enhanced reimbursement and other incentives to co-locate primary care practitioners at their program sites.
A Bazelon Center study, Get it Together: How to Integrate Physical and Mental Health Care for People with Serious Mental Disorders, found that coordinating care across separately operating offices and systems was difficult, time-consuming and less effective than care provided in integrated settings. Co-location is by far the most successful approach to ensuring that health and mental health problems are appropriately and efficiently addressed.
For individuals with serious mental illness who use the public system, co-morbidity is high. Many of them have high rates of diabetes, heart conditions, cancer and other chronic illnesses, as well as serious mental illnesses. Moreover, since certain psychiatric medications can lead to health risks such as obesity and hypertension, screenings and wellness services are also quite important. Overall, the physical health of people with serious mental illness is generally poor and one study found that these individuals have a life expectancy that is 25 years less than the general population.