Thursday, June 11, 2009

Primary Care Integration

Not much stellar came out of Washington during the past years in regards to mental health. The New Freedom Commission Report and SAMHSA's 16 State Study were probably the most worthwhile products of those eight years. The New Freedom Commission Report didn't have teeth and was followed up with few funds. The "Transformation Grants" that followed the New Freedom report have generally been viewed as a waste of money by those not bought by the grants.

The 16 State Study was excellent but essentially told us what we already knew. It was a wake up call in many respects.

It would seem that it even woke up SAMHSA, for there has been significant movement related to one of the issues highlighted in the study. The study's research revealed that individuals with severe and persistent mental illness die 25 years earlier than the population without the disabilities. There is a whole panapoly of reasons for this but one of them has been the silos that have built for behavioral health care and physical health care in our health care delivery systems.

A few months ago, SAMHSA let an RFP to fund 11 primary care integration sites with the purpose of promoting primary care services for the target population in community mental health centers. The funding level was not piddling, either, at 1/2 million dollars a pop. The request was written well with a significant number of points allowed for the research and outcomes management component of the projects.

There are pockets of excellence in the US related to primary care integration and a growing interest in doing something about the problem. I believe there is some real promise for successful, replicable projects to come out of this funding.

Good job, SAMHSA!

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