Raise your hand if you don’t know by now that Oklahoma is one of the least healthy states in the nation.
Oklahomans eat too much, smoke too much and exercise too little. Our life expectancy is about three years shorter than the national average. And it’s much worse for Oklahomans with mental health disorders. Statics say they’re unlikely even to make it into their 60s.
Poor health outcomes may be caused, in part, by our fragmented, underfunded health system. The Commonwealth Fund, a private foundation that promotes health care improvement, ranks Oklahoma 50th for health system performance. We come in 45th nationally in per capita funding for mental health treatment.
An effort is afoot to improve matters. The Centers for Medicare and Medicaid Services is accepting proposals from states to establish health homes for Medicaid beneficiaries who have both serious mental illness and chronic medical conditions. Health homes aren’t bricks-and-mortar structures, but rather health service delivery models that coordinate patients’ care.
Those participating in health homes have a care manager who oversees the provision of physical and mental health services. The care manager makes sure patients access care at the most appropriate and affordable levels, and coordinates communication between providers so that patient information isn’t overlooked and services aren’t duplicated. Health homes are designed to prevent, for example, a general internist from prescribing a medication that interferes with a patient’s psychiatrist-ordered anti-depressive drug.
Rita Vandivort-Warren, a public health analyst in the Department of Service Improvement at SAMHSA’s Center for Substance Abuse Treatment said in a 2010 article that the integrated health home model can greatly benefit individuals with mental health disorders. “Those with these chronic illnesses tend to have more complex, long-standing needs and more variety of different providers involved. In other words, they have to go to many different providers who may not communicate with each other and who never see the whole person, only the illnesses they treat.”
Through our Integrated Health Clinic – a one-day per week medical clinic operated at Family & Children’s Services in conjunction with Morton Comprehensive Health Services – we’ve already tiptoed into the area of coordinating physical and mental health services. Results from this collaboration have been extremely promising and strongly suggest that expanding care coordination will have a life-changing – and hopefully, life-extending – impact on a compromised, vulnerable population.