March 30, 2022
Given the strong connection between biological and psychological well-being, addressing mental illness in the primary care space not only addresses behavioral health, but also supports physical health. A study published in the New England Journal of Medicine found that patients receiving Collaborative Care to address depression had greater overall improvement across glycated hemoglobin levels, LDL cholesterol levels, and systolic blood pressure in comparison with patients receiving standard care.1 This is one of many studies supporting how patient-centered collaborative care impacts chronic physical illness and depression. Integrating behavioral health into primary care reduces stigma surrounding psychiatric diagnoses by conveying that behavioral health is an indispensable piece of the pie in addressing overall health.
In today’s national healthcare system, physical and behavioral health are largely fragmented and conceptualized as separate in the eyes of many. Unfortunately, this reductionism compromises an appreciation for the body as an interconnected whole. Not only is there cross-talk between each of the body’s biological systems, but it is becoming evident that the mental and physical states of a person strongly influence one another. Research illuminates that comorbid mental and physical health-related adversity is the rule rather than the exception, with a co-occurrence of depressive symptoms as high as 80% among patients with chronic obstructive pulmonary disease,2 and as high as 85% for individuals with chronic heart failure.3 The list stretches on, with conditions such as arthritis, asthma, back pain, chronic bronchitis, and hypertension strongly associated with the presence of major depression.4
The tango between physical and behavioral health is dynamic and complex. Researchers find the pathway between physical and behavioral health is bidirectional. That is, medical conditions put people at risk for mental illness, and mental illness may in turn put people at risk for certain medical conditions. For example, the burden of pain and inflammation due to poor physical health can take a significant toll on a person’s well-being. Living with unrelenting anxiety and depression can also impact one’s biology through chronic activation of the autonomic nervous system.
As rates of both mental illness and chronic disease soar, care that addresses the whole person is increasingly crucial. Concert Health is contributing to a movement towards a broader view of health by addressing behavioral health in the primary care setting.
The word “health” derives from the Old English word for “whole.” The World Health Organization defines health as a “state of complete physical, mental and social well-being.” Hopefully this sentiment permeates into societal understandings of health, and is reflected in policies that embrace a holistic and collaborative vision of health and vitality.
As budding awareness of the multi-faceted nature of health grows, Concert Health will be providing a symphony of multidisciplinary care from primary care providers, behavioral care managers, and psychiatric consultants.
- https://www.nejm.org/doi/full/10.1056/nejmoa1003955
- Yohannes AM, Willgoss TG, Baldwin RC, Connolly MJ. Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry. 2010;25(12):1209-21.
- https://onlinelibrary.wiley.com/doi/10.1002/gps.2463
- https://pubmed.ncbi.nlm.nih.gov/18774423/