Integrated care?

a diagram by fuzzyjay

Pat Deegan bites her nails at the prospect of integrated care for mental health care (The same thing is happening with addiction treatment):

Is recovery going the way of the dinosaur? Is recovery-transformation an old idea that should give way to more enlightened policies of integrated, co-located behavioral and physical healthcare services?

These days, I am hearing a lot about the integration of physical and behavioral health services. I am hearing about the co-location of physical healthcare services in behavioral healthcare centers. I am hearing about federally qualified healthcare centers and their capacity to serve those of us diagnosed with major mental disorders. I am hearing how, in some states, recovery has “fallen off the radar” and has been replaced with initiatives to support access to medical care and physical health services.  A long-time advocate recently told me: “Recovery is old school.  Today we are about integrated care.”  

I don’t know about you, but the last time I was at my annual physical (April 2012), my primary care physician was anything but “integrated” and “whole health”.  I had the standard 20 minute physical exam that never once addressed my psychiatric disability.  After my annual physical, I was in the reception area, getting my referrals for an annual mammogram, bone density and eye exam.  Although a wall separated the medical reception area from the medical exam rooms, I heard a patient yell through the barrier, “And…I’ll need my script for citalopram increased by 10 milligrams.”  To my astonishment I heard the muted physician’s voice answer back through the wall…”OK”.  I found myself wondering, “So this is integrated health and behavioral healthcare?”