By Tamera Manzanares
A patient goes to the doctor and is diagnosed with diabetes. She is overwhelmed by physical symptoms and disheartened by fear, worry and sadness. The prospect of making life adjustments to manage her disease seems insurmountable. Another patient complains of sleep problems. He’s recently experienced a major loss and the resulting stress and anxiety is affecting his work and ability to enjoy outdoor activities and exercise. He’s started smoking again and is not eating healthy. These situations seem different, but both show the connection between physical and emotional health and the overall effect that can have on a person’s wellbeing. This understanding has spurred a relatively new healthcare approach that brings behavioral health specialists into traditional medical clinics to work with healthcare providers in addressing patients’ mental and physical symptoms.
Lilia Luna, a clinical psychologist, leads the behavioral health teams at Northwest Colorado Visiting Nurse Association’s Community Health Centers in Steamboat Springs and Craig. Lilia works hand-in-hand with medical providers to promote the health of patients who may be struggling with chronic medical problems, stress, sadness, substance use, sleep problems and weight management. Patients often work with both medical and behavioral health providers during the same visit. “All people struggle at some point or another with emotional and behavioral health issues – this is just the reality of being a human being,” Luna said. “My hope is that now people will know they can come to the VNA to get comprehensive help when they need it.”
Chronic health problems such as heart disease, diabetes and depression are an ever-growing burden on individuals, families, communities and healthcare systems. This has motivated programs such as Colorado’s State Innovation Model, which aims to integrate physical and behavioral health care in more than 400 primary care practices and community mental health centers in the state. This will make mental and behavioral health support more accessible and improves the chances of helping people who otherwise would not seek care in a mental health office or clinic. As many as 85 percent of physician visits are for problems that have a significant psychological and/or behavioral component, according to American Psychological Association. “With demand for behavioral and medical services being so high, integrated care just makes sense,” Luna said.
This approach also decreases the social stigma often associated with mental health struggles, improving chances that people will get help when they need it. A 2002 study in the American Journal of Psychiatry found that 45 percent of people who committed suicide had visited their primary care provider within the previous month. “The hope is that having a behavioral health team within primary care will increase early detection and treatment to prevent suicide,” she said.
In addition to working with people during medical appointments, Luna and the behavioral health team are available to meet individually with patients four to six times. Discussions often focus on the relationship between patients’ thoughts, feelings, behaviors and values and identifying healthy coping strategies to promote immediate and long-term health. If they need and are interested in more in depth support, the behavioral health team refers them to mental health professionals in the community. Northwest Colorado VNA’s Community Health Center is accepting new patients and is available to all residents, regardless of insurance status. If patients to not have insurance, primary care services are provided on an income based sliding fee scale. For more information or to make an appointment, call 970-879-1632 in Steamboat Springs or 970-824-8233 in Craig.