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The Community Clinic of Maui has a fully integrated behavioral health and primary care system. At each of the clinic’s three sites there are behavioral health providers ... read more
Behavioral health is the term used to describe care given to people to promote optimal emotional and social well being. It puts the emphasis on the activities of living rather than a state of mind, in contrast to the term “mental health.” For our population of recent immigrant, poor, non-majority culture families, neither term may resonate. Our clinicians in the field are working to provide the highest standard of behavioral health care using terminology and practices that are supportive of the patient’s cultural experiences. MCN gathers materials here that promote integrated behavioral health practices in primary care which address the complex social, cultural, economic, and justice factors that contribute to disease burden.
The Health Resources and Services Administration (HRSA) reports that:
- Depression is the third most common reason for a visit to a federally funded health center after diabetes and hypertension.
- Suicide is a major public health issue; there is 1 suicide every 15 minutes.
- Children and youth who are bullied are more likely to be depressed, lonely, anxious, and have low self esteem and think about suicide.
- About one in four adults suffers from a mental disorder in a given year.
- Visits to emergency rooms involving the misuse of prescription drugs have doubled in the last five years.
- Nearly 70 percent of HRSA-supported health centers provide mental health counseling and treatment; almost 40 percent provide substance abuse counseling and treatment; and close to 20 percent offer 24-hour crisis intervention services. All provide referrals to substance abuse and mental health services. About 4,000 mental/behavioral health providers work in health centers. Their services account for approximately 5 percent of patient all patient visits.
In addition to these figures, clinicians also need to be aware of the “perpetual mourning” that is often associated with the experience of immigration (ref). Loss, grief, isolation, discrimination, confusion and uncertainty add to stressors of poverty, disease and biological predispositions. For some, the premigration experience in their sending community was associated with violence and upheaval. The migration journey itself, particularly for the poor or undocumented, can be fraught with violence and risk. In all cases, clinicians need to understand signs and symptoms of post-traumatic stress disease (PTSD) in both children and adults.
Finally, this section also recognizes the improvements made in attending to patient-centered, integrated behavioral health. Issues in constructing group sessions so that people are best able to respond. For instance, one center had patients name their group, and they called it “Salud de Emotiva”. Others use motivational interviewing, tailor made activity programs, and recreation opportunities to boost behavioral health efforts. Whether it is in learning about the relationship between bandanas and women’s health, or migraines and spiritual grief, we all have opportunities here to learn from each other and our courageous patients.
Webinars on Behavioral Health:
- Integrating Behavioral Health in Community and Migrant Health Centers: Motivation, Readiness, & Cultural Challenges, August 23, 2012
PRESENTED BY: Tillman Farley, MD Executive Vice President for Medical Affairs, Salud Family Health Centers and Jennie McLaurin, MD Specialist, Child & Migrant Health, Migrant Clinicians Network
- Care for the Whole Person: Integrating Behavioral Health and Primary Care, March 14, 2012
PRESENTED BY: Dr. Martha A. Medrano, MD, MPH, Director of Behavioral Health at CommuniCare Health Centers in San Antonio, Texas