When medical and behavioral health care are coordinated
When my family and I moved to Binghamton in 2003, we put a basketball goal at the top of our driveway.
Several young men began to play daily pick-up games, including young Memphian who immigrated to the United States from Sierra Leone at age 5 after he and his family suffered through a bloody civil war in that country.
While his story presents an inspiring picture of Memphis’ giving culture, it also demonstrates a profound lack of support for some of our city’s most vulnerable — those quietly suffering from mental health issues.
On arriving in the United States, Catholic Charities helped the young man’s mother learn English and gain employment. The Neighborhood School in Binghamton welcomed him and his siblings. Several families guided them through the complexities of a new culture. One neighbor helped his mother purchase the home they were renting, while others became like second parents.
The young man’s mental health battle began during his freshman year of college when his thoughts became increasingly disturbed. He stopped sleeping normally and spent hours reading the Bible, unable to escape fearful thoughts.
Things spiraled until he had a complete mental breakdown, forcing him to leave school and return to Memphis, where he was hospitalized and diagnosed with bipolar affective disorder.
After his release from the hospital, he had trouble securing ongoing care. He struggled to find a clinic to handle both his mental and primary care needs, especially after he lost TennCare health insurance following his 21st birthday. One mental health clinic asked for more than $100 in cash before refilling his medications, which didn’t include the cost at the pharmacy. He simply couldn’t afford it all.
A few months ago, his symptoms began to escalate again. This time, he found a new model of care that addressed both primary care and behavioral health needs in one place — despite his lack of insurance.
At Resurrection Health, his primary care doctor and psychologist share information and make joint treatment decisions. Because Resurrection Health is affiliated with a larger behavioral health provider, Cherokee Health Systems, he receives additional care from an experienced psychiatrist.
Community health coordinators ensure he makes his appointments and receives his medications. And, since the care is under one roof, no one in the waiting room knows whether he is getting a flu shot or being evaluated for bipolar disorder, removing the stigma of being treated for mental health.
Having affordable primary and behavioral care available on the same day in one clinic has been transformative. Unfortunately, his struggle isn’t rare.
The Mid-South famously possesses a giving culture, but it falls short in supporting those with mental health problems. A study by the Urban Institute found that an estimated 56 percent of state prisoners and 64 percent of jail inmates have a mental health or substance abuse diagnosis.
Consider how widely available integrated primary care and behavioral health services might reduce homelessness, crime and the cost of imprisoning people who just need proper care.
Integrated care is a relatively new trend, and Cherokee is a nationally recognized integration pioneer. Most community mental health facilities have a primary care doctor available to their patients by outside referral only.
Conversely, primary care clinics rarely have on-site mental health professionals. True coordinated care — with medical and behavioral health services in one place at the same time — is exceptional, especially for our neighbors without health insurance. To better meet the needs of Memphians suffering from mental illness, we must prioritize the widespread expansion of truly integrated care.
Dr. Rick Donlon is a combined internal medicine and pediatrics physician and co-founder of Resurrection Health, a community of Christian disciples using health strategies to restore spiritual, physical and social wellbeing by developing leaders and providing compassionate care.