Opinion: Utah is facing a mental health crisis. Integrated health care could be the solution

When I started my first job in the mental health field, I didn’t quite understand the mental health crisis that Utah was facing until I met Emily. Emily was a single mother who was experiencing significant health concerns, undergoing multiple surgeries, while trying to raise three children on her own. Not only was her physical health declining, but so was her mental health. However, with her limited time, money and lack of insurance coverage, she was having to make the decision to treat only her physical health or her mental health.
As it became clear that her mental health and physical health were closely intertwined, it didn’t seem fair that Emily had to choose to only treat one. Her doctor urged her to get connected to a therapist or mental health counselor to treat her depression. But because of the cost of mental health care in the rural area she lived in, she couldn’t afford it. Her depression worsened, which only made her physical pain worsen. Are you seeing the endless cycle here?
Like Emily, many Utah citizens are stuck choosing between getting treated for physical or mental health. It is undeniable that Utah is facing a mental health crisis. We have one the highest rates of suicide in the entire nation, and almost half of the population has reported experiencing major depression and anxiety. Individuals and families might feel reluctant to get mental health care because of the stigma surrounding mental illness.
There are also long waiting lists to see a mental health professional, due to the mental health provider shortage in every county. Additionally, private practices might not work with most insurances or may not take insurance at all, making mental health treatment unaffordable. Though most people say that mental health care is just as important as physical health care, the resources are not the same for both.
Collaborative care is one way to fix this ongoing issue. Collaborative care, or integrated health care, is a model that makes it easier for primary care providers to include mental and behavioral health screening, treatment and specialty care into their practice. This integration can look different depending on the patient, but it always involves collaborations between primary care providers and specialized care providers for mental health. This collaboration is crucial to getting patients quality care in all areas of their health.
This is especially relevant as Utah’s National Alliance on Mental Illness just announced that its services are currently suspended due to lack of funding. Previously, NAMI was providing free mental health support to all populations in Utah and was making huge strides on getting mental health care to all who needed it. With these free programs not having the funds to provide support anymore, our Utah citizens are at risk. It is critical that we all have an easy way to access mental health care without the long waiting lists to see a therapist or the outrageous out-of-pocket costs per session.
Collaborative care has been shown to prevent suicide and overdose. In fact, this model helps physicians detect mental illness symptoms before a major crisis point. Because asking a question like “In the past week, have you had thoughts of killing yourself?” is proven to be lifesaving, making this a part of primary care is a critical part in lowering suicide rates in our state.
There are, of course, limitations with integrated health care models. One major limitation is that providers can typically only provide short-term care, and then patients are usually referred out to other providers after about six months of work together. However, this is much better than getting put on a waitlist. Patients can get connected to the mental health care they need and connected to resources in a more effective way through collaborative care.
When mental health care is provided hand in hand with physical care, there are obvious benefits. Think back to the story about Emily. If Emily had been able to have access to integrated care, both her physical and mental health symptoms could have been managed, and the health care providers could work together to find the best care plan, made specifically for her. Additionally, her mental health care would continue to be covered by her insurance, waiving costs and making it more affordable.
If health care agencies truly want to show they care about their patients, integrated health care needs to be more accessible and available to all.
Lily Udall is a MSW student at the University of Utah who is passionate about mental health in Utah.