According to the Centers for Disease Control and Prevention, mental health refers to the psychological, emotional, and social well-being of an individual. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Taking care of one’s own mental health can make a huge difference in a person’s overall health and well-being. Mental health challenges, particularly depression and serious and persistent mental illness (SPMI), can increase the risk of physical health problems such as stroke and heart disease. Likewise, living with a chronic health condition can increase the risk of mental illness (CDC, 2019). In a simple explanation, mental and physical health are very connected.
In Central Oregon from 2012-2015, 35.7%, 23.1%, and 28.1% of adults were diagnosed with depression in Crook, Deschutes, and Jefferson Counties, respectively (RHA, 2019). Approximately one in four adults over age 55 reported a diagnosis of depression (RHA, 2019). Among adults with diabetes, approximately 50% also reported depression (RHA, 2019). While representing a smaller percentage of the population, just over 1% of individuals with a severe and persistent mental illness (SPMI) such as schizophrenia, experience significant struggles managing health conditions resulting in lifespans up to 25 years shorter than the general population (NIMH, 2019). These individuals benefit significantly from intensive coordination of care and outreach activities, which are centralized in the more populous centers of Central Oregon and less available for those in remote areas.
In fact, behavioral health concerns are most often discovered in the primary care setting, yet only about 20% of those in need go on to access specialty behavioral health care (Kessler, 2008). Specialty behavioral health is defined as mental health, substance abuse, and developmental services that are delivered outside of primary care. Most primary care clinics in Central Oregon now have integrated behavioral health consultants (BHCs) who provide assessments and short-term interventions. Still, people who need a higher level of behavioral health care often struggle to access and engage in that care outside of the primary care setting.
Primary care and specialty behavioral health are interdependent; however, the promise of integrated behavioral health in primary care settings will not be fully realized without an adequate specialty behavioral health system for patients who need a higher level of care. In order to meet the behavioral health care needs in Central Oregon, the primary care and specialty behavioral health care systems must work together. Further complicating this situation are the differences that exist in coordination between primary care and specialty behavioral health, creating fragmentation and safety concerns. Primary care clinics in Central Oregon are struggling to meet the needs of their patients without adequate access to and coordination with specialty behavioral health care.
"Looking back over the past year I have been amazed at how your work has changed the landscape of our community. I have seen so much enthusiasm to 'Put the head back on the body' and though the concept may be easy to embrace, putting it into practice is a whole other story. Many outpatient specialty behavioral health clinicians believe in the idea but didn’t know where to start. After the Building Bridges meeting in Bend, I think it created excitement for many specialty behavioral health clinicians because for the first time they could see something tangible that they could do to help." Kevin Shaw, LCSW CADC III
• Almost 88% of clinics said they are somewhat/very interested in increasing completed referrals & communication with outside specialty BH
• 72% of clinics said they are somewhat/very interested in increasing patient engagement in specialty BH treatment