Mental Health Professionals in Medical Settings: A Primer

Both students and practicing mental health practitioners will find a well-researched, practical model for comprehensive, well-coordinated, and quality care that all patients deserve.

One of the most significant events in the history of health care is the development of separate and parallel systems for mental health and medical care. Patients, however, want health care that is better coordinated, more personalized, more accessible, more timely, and less cumbersome to receive. These patient-wants reinforce what we know about patient needs for better integrated care and more collaborative health care, as shown by the following data:

• 50% of mental health care is delivered by primary care physicians.
• 67% of all psychopharmacological drugs are prescribed by primary care physicians.
• 50-70% of all primary care visits are for psychosocial concerns.

This book illustrates the importance of taking an integrated approach to health care and outlines the skills that a mental health professional needs for working in a medical setting. The authors, trained in health psychology, psychiatry, family medicine, and marriage and family therapy, build a persuasive case for their holistic, biopsychosocial approach to the traditionally fragmented fields of primary care and mental health care.This is a primer for mental health professionals working in a medical setting. Part I discusses health care settings. Chapters 1 and 2 describe the specific cultures of primary care, specialty care, and mental health care, and Chapter 3 discusses ways to balance the clinical, operational, and financial perspectives of health care. Part II provides information on how to build collaborative medical care, including getting started (Chapter 4), expanding the therapist's identity and role in medical clinics (Chapter 5), working within the medical system's organizational framework (Chapter 6), working with the common problems that patients present in primary care (Chapter 7), and ways to promote healthy behavior change (Chapter 8). The book concludes by highlighting some of the opportunities that exist for therapists who want to be part of this important shift in how health care is provided.

Richard J. Bischoff, Ph.D., is Director of the Marriage and Family Therapy Program at the University of Nebraska-Lincoln.

Richard L. Heinrich, M.D., is Medical Director of Hospice of the Lakes, and Assistant Medical Director of the Division of Behavioral Health at the HealthPartners Medical Group and Clinics in Minneapolis, MN, where he practices geropsychiatry. With Dr. Peek, he has co-led HealthPartners' primary care/mental health integration projects since 1991.

Jo Ellen Patterson, Ph.D., is a faculty member in the Marriage and Family Therapy Program at the University of San Diego and the Director of Behavioral Sciences for the Sharp Health Care Family Medicine Residency. In addition, she is collaborating with the Department of Family Medicine at the University of California at San Diego on the integration of mental health interns and family medicine residents at the UCSD family medicine clinics.

C.J. Peek, Ph.D., L.P., is a psychologist who consults in the areas of health care collaboration, communication, clinical communication, and interprofessional relationships. Formerly of the HealthPartners Medical Group and Clinics in Minneapolis, MN, Dr. Peek founded and helped lead its primary care/mental health integration projects from their start in the mid-eighties through 2001.

Joseph Scherger, M.D., M.P.H., is a family physician with a long history of collaboration with mental health providers, both in training and practice. He is currently Dean of the College of Medicine at Florida State University in Tallahassee.