At his yearly physical, a patient is found to be 35 pounds over ideal body weight. He has hypertension, and his lab results indicate prediabetes. His doctor urges him to change his diet, be more active, and lose the extra weight to reduce his risk for stroke, heart disease, and diabetes.
The patient acknowledges that he should. But at his next yearly physical, he’s still 35 pounds overweight.
In that all-too-common scenario lies the possibility for a new approach to health care, one that simultaneously provides help for behavioral as well as physical issues. “The goal is to help people make better choices—about things like what they eat, how they exercise and about alcohol and nicotine—and thereby avoid many chronic health disorders,” says Frank A. Ghinassi, PhD, ABBP, Senior Vice President, Behavioral Health and Addiction at RWJBarnabas Health (RWJBH), and President and CEO of Rutgers University Behavioral Health Care.
“Through integrated care delivery, we want to treat both body and mind, preferably in the same location and during the same health care visit,” he says.
In the case of the overweight patient, for example, the primary care provider will look to determine the cause of the patient’s inability to lose weight. “Is the issue genetic? Does the patient have a low metabolism?” asks Dr. Ghinassi. “Or is there a mood disorder that’s affecting energy level and motivation?”
Once barriers to a healthier lifestyle are identified, doctors and behavioral health specialists can work together to develop solutions tailored to the patient’s specific needs.
An Integrated Approach
“Often, people with behavioral and addiction disorders are treated ‘from the neck up’ and are referred to dedicated behavioral health offices,” says Dr. Ghinassi.
But that approach can create roadblocks. “Maybe the patient can’t get an appointment for three weeks, or he doesn’t like the idea of walking into a building that says ‘counseling services’ or ‘psychiatry’ on the sign,” he explains.
To provide coordinated care, RWJBH and Rutgers University Behavioral Health Care are bringing services closer together. “At many of our primary care and pediatric delivery sites, primary care physicians work with psychologists or social workers who are located in the same office suite or in the same building,” says Dr. Ghinassi. “A patient can be offered a chance to meet the physician’s behavioral health colleague even before leaving the initial appointment, find out what might be possible, and perhaps find it easier to commit to following up with a subsequent call or visit.” The next evolution of care at RWJBH and Rutgers University Behavioral Health Care will be to have a clinical social worker or psychologist located right in the same office space as the primary care provider.
Integrated health care is the future, Dr. Ghinassi believes. “People tend to come to a health care system when they’re in crisis—they need coronary artery surgery, for example, or their depression makes them unable to function in daily life. Of course, we’ll always be there for those people,” he says.
“However, we’re evolving to an equal focus on early screening and intervention. Together, RWJBarnabas Health and Rutgers University Behavioral Health Care are on a mission to improve the health and life satisfaction of patients and families throughout New Jersey.”
For help accessing mental health services, call the RWJBarnabas Health Access Center at 800.300.0628.