Op-Ed: Why NJ Should Integrate Mental, Physical, Behavioral Healthcare
State’s plan to put mental health and addiction services under DOH control will ‘improve the well-being of the people of New Jersey’
It’s National Health Center Week, a time to recognize the high-quality healthcare our community health centers provide each year to more than half a million New Jersey residents at more than 100 sites throughout the state.
The community health centers in New Jersey are part of a movement toward what’s called the “Patient Centered Medical Home.” Developed 50 years ago by pediatricians who were trying to provide better-coordinated care for chronically ill children, the medical-home model urges patients to receive most of their care in the offices of their primary-care doctors, with consultants coming and going. The goal is to create a system where healthcare providers treat the whole person — simultaneously addressing physical, mental, and behavioral healthcare in the same setting. Research shows that integrating mental, behavioral, and physical healthcare is the most effective way to treat the “whole person.” It results in improved health outcomes for patients, while reducing the cost of care.
While the provider community has adopted this evidence-based, integrative approach to healthcare, our state system is still organized into three different regulatory and funding silos addressing mental, physical, and behavioral healthcare separately. Given what we know about the relationship between physical health and mental health, the current state structure no longer makes much sense. That’s why I’m supporting the state’s plan to transfer the Division of Mental Health and Addiction Services from the Department of Human Services to the Department of Health. The proposed restructuring will provide a coordinated oversight approach, which, in turn, will enable healthcare providers to collaborate more effectively and improve the well-being of the people of New Jersey.
Integrating health management
Integration means treating mental health and behavioral healthcare problems no differently than chronic conditions such as hypertension, heart disease, diabetes, or obesity. Integrated healthcare also removes the stigma associated with receiving mental and behavioral health treatment and treats substance abuse as the public health crisis it is.
In fact, more than one-third of all mental healthcare in the U.S. is already provided in the primary care setting. Demand by patients for mental healthcare has increased such that if primary-care doctors didn’t offer it, many people would go without it. Our health center has offered limited mental health services since 2008, but the state regulatory structure has constrained what we are able to offer our patients.
The designation of the Department of Health as the single state agency to perform the administrative and operational functions of mental health and addiction services will expedite the important integration of physical, mental, and addictions health management. As the state’s public health agency, the Department of Health is well positioned to identify risk factors, increase awareness about behavioral health and the effectiveness of treatment, reduce health disparities, and, ultimately, remove the stigma that prevents people from seeking and receiving care.
Confidence in the DOH
New Jersey’s community health centers receive $32 million in funding each year from the state Department of Health to provide healthcare for uninsured residents. Over many years and multiple administrations, we have worked closely with the DOH on numerous population health initiatives that support improved well-being for the most vulnerable in our local communities.
I have great confidence in the department’s ability to meet this new challenge. It oversees inspections and enforcement of regulations for more than 2,000 licensed healthcare facilities and provides $1.5 billion in grant funding each year for early intervention services, cancer education and early detection, community health centers, healthcare facilities, local health departments and faith-based and community-based partners. This reorganization plan should be seen as a first step, which will open the door for many discussions with patients, families, and providers to develop this new system of integrated care.
Instead of discussing whether this is the right time for integration, we need to think about what is the best system of care for New Jersey residents and move swiftly towards that goal. We need to support the many providers in this state who are adopting cutting-edge approaches and serving patients who have both physical and mental health needs despite the barriers in the system. We also must support the agencies that are committed to providing seamless and integrated services in a truly holistic or “patient-centered” way.