This year’s Annual Meeting in Philadelphia May 5-9 will encompass John Oldham’s presidential theme of Integrated Care by providing the most comprehensive array of presentations ever offered at an APA Annual Meeting. More than 20 presentations on this topic will be offered by top experts in the field including Wayne Katon, M.D., Benjamin Druss, M.D., Jurgen Unutzer, M.D., Roger Kathol, M.D., Joe Parks, M.D., Benjamin Miller, Ph.D., Frank deGruy, M.D. and others.
Integrated care is conceptualized as a range of collaborative efforts with our primary care colleagues in diverse settings to improve overall health. This runs the spectrum from using our expertise in primary care settings to help with the detection and effective treatment of mental illness to engaging primary care to help with the treatment of medical problems in our mental health settings that are contributing to increased mortality. The outcome of these partnerships can result in “improved lives and lifespans” as stated by Steve Sharfstein, M.D., CEO of Sheppard Pratt Health Systems, in a recent AJP editorial. In addition, there is an emerging database showing cost savings in the overall health care system when integrated models of care are implemented.
Integrated care is different from standard consultation in that it encompasses several “core principles” recently established by the Advancing Integrated Mental Health Solutions (AIMS) center at the University of Washington in Seattle. Led by Dr. Unutzer, Director of the AIMS center and Principal Investigator of the “Improving Mood: Promoting Access to Collaborative Treatment” (IMPACT) studies, a Summit was held in May 2011 that resulted in a well thought out inventory of essential values prominent in integration efforts. The core principles of effective integrated care include person-centered care teams providing evidence-based treatment to a defined population of patients using a measurement-based ‘treat to target’ approach.
The idea of psychiatrists assuming responsibility for a population of patients is new for many and a prominent feature of this model in both primary care and mental health settings. This system of team-based care also provides a way to extend limited psychiatric expertise across larger groups, providing one promising solution for the shortage of psychiatrists. It provides a framework for thinking about our role in communities as we position ourselves for healthcare reform and market our value in evolving systems of care.
Integrated Care has a robust evidence base consisting of more than a decade of studies from multiple settings across the country. From the pioneering work spanning Dr. Katon’s, 30-year career, to the repeated success of IMPACT trials extended to other populations, the success Dr. Druss has shown in improving the health status of persons with mental illness in public settings and more, integrated care has demonstrated proven, effective models with psychiatrists prominently featured as essential to the success of such programs. However, psychiatrists in many clinical settings have not had the training opportunities until now to join this healthcare revolution in well-informed and meaningful ways. This year’s annual meeting in Philadelphia will provide a much-needed venue to discover and learn more about this evolving subspecialty area, allowing attendees to sift through the data and experiences of those working in the field.
Some highlights of the meeting include the first course in Integrated Care ever offered at the annual meeting on Saturday, May 5 (Course 4, The Integration of Primary Care and Behavioral Health: Practical Skills for the Consulting Psychiatrist), and a Saturday symposium on financing Integrated Care (Symposium 9, Financing Sustainable Interdisciplinary Care in Psychiatric and General Medical Settings). On Sunday, May 6, a featured highlight of the meeting is an invited forum (Forum 3, The Future is Now: The Evolving Role of Psychiatry in the Integration of Primary Care and Behavioral Health), bringing together top experts in the field in a discussion group format to share ideas and encourage dialogue with attendees. Monday, May 7 offers several top-notch presentations, including a Presidential Symposium (New Approaches to Integration of Mental Health and Medical Services), a symposium with Jeff Brenner, M.D. from Atul Gwande’s New Yorker “hot spotters” article (Symposium 47, Inventing the Neck: Connecting Body, Mind, World from the Top Down and Bottom Up) and a seminar (Seminar 15, Integrating Mental Health Services Within a Primary Care Setting: Effective Strategies and Practical Tips) with Ben Miller, Ph.D., President of the Collaborative Family Healthcare Foundation (CFHA). The selections continue on Tuesday, May 8, with a symposium offered by AADPRT (Symposium 82, Integrated Care and the Future of Psychiatry: Teaching Psychiatry Residents and Fellows to Work at the Interface of Mental Health and Primary Care) and a workshop bringing together the three disciplines on integrated care teams (Workshop 95, Primary Care Behavioral Health Integration: Roles of the Key Team Members). Wednesday, May 9, wraps up with an AACP workshop (Workshop 133, Roles for Psychiatrists in Integrated Care) highlighting key points from the chapter on Integrated Care included in the soon-to-be released Textbook of Community Psychiatry. This full list of presentations is available on the APA website, in the Daily Bulletin at the meeting and as a comprehensive handout with a companion Related Topics list.
Lori Raney, M.D., chairs the APA’s Workgroup on Integrated Care and can be reached at email@example.com.