Primary care and mental health

The primary care physician has typically been viewed as someone who sees patients for preventive care, diagnosis, and referrals to specialty providers, all related to physical issues. However, with a growing shortage of psychiatrists and an increase in costs for patients, it is becoming more common for a primary care provider to treat patients for mental health concerns as well.

Primary care providers can provide mental health services on a relatively basic level, diagnosing and treating a patient for conditions such as depression or anxiety. Most often, the treatment consists of medication prescriptions but should also include collaborative care, coordinated for more enhanced treatment by a mental health professional.

The National Institute of Mental Health (NIMH) states that “Collaborative Care has been found to improve quality of care, satisfaction with care, and both mental and physical health outcomes.” Unfortunately, primary care providers have not traditionally been paid for additional collaborative care efforts. Effective January 1, 2017, however, Medicare began reimbursing providers who collaborate care with mental health providers for those patients with mental or behavioral concerns.

The hope is that private insurance companies will follow suit. NIMH also states that, as of December 2016, “it is believed that only about 10% of patients with depression receive appropriate mental health care when visiting their primary health care provider.” Communication with a patient’s specialty providers, including their mental health provider, is a crucial component of quality coordinated care. The patient’s physical medical history can impact mental and behavioral health treatment and vice versa.

A patient with depression, anxiety, or addiction issues may be more willing or better able to visit a primary care provider for basic mental health treatment. The primary care provider can then manage that patient’s care, ensuring that a referral to a mental health professional includes information about the patient’s physical health, through shared electronic health records (EHRs), for example. Collaborative care, coordinated between the primary care physician and the mental health provider, helps patients access the care they need and improves patient outcomes.