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MEN-006: Improving Access to Mental Health Care

Improving Access to Mental Health Care: The Wisconsin Medical Society (Society) recognizes the importance of quality care for people with mental illness, and that our health care system must do more to detect and care for those with mental illness. The Society therefore recommends the following focus areas to improve access to and quality of mental health care:

  1. Screening and Early Detection
    Screening and early detection ensures that all patients in need can be steered toward care. The Society supports efforts to:

    1. Increase early detection and treatment of depression, anxiety, and substance abuse in primary care settings, and supports screening tools that improve consistency of detection.
    2. Increase access to psychiatric consultation and referral sources for patients identified as having a need for psychiatric evaluation and treatment as a result of screening in primary care settings.
    3. Train school staff, law enforcement, and the community at large on ways of identifying children and adults who are in a state of crisis and how to proceed (mental health first aid).
    4. Regularly screen returning veterans, and their families, and refer to local mental health and life adjustment resources.
    5. General screening should include questions to identify war veterans and their family members.
  2. Workforce Development
    Meeting the needs of patients with mental illness requires a sufficient and properly trained workforce. The Society will:

    1. Support the promotion of training psychiatrists and encouraging psychiatrists to practice in underserved areas.
    2. Support funding mechanisms to encourage psychiatrists to practice in underserved areas and populations.
    3. Consider ways to connect psychiatric services to those in need in shortage areas through expanding training programs, telemedicine and consultations to primary care providers in underserved areas.
  3. Intervention and Referral to Treatment
    Once recognized, patients with mental illness must be referred consistently to appropriate treatment services. The Society supports efforts to:

    1. Provide psychiatric consultation in the primary care and emergency care setting.
    2. Ensure immediate intervention through such consultation, and assist patients in the referral process when necessary. Available services must include pediatric psychiatry, alcohol and other drug assessment, and acute inpatient care services.
    3. Integrate emergency mental health response and intervention into postdisaster emergency medical response care.
  4. Intermediate Care and Alternative Delivery Models
    To be effective, recognition and assistance to patients with mental illness cannot be limited to a strictly clinical setting. The Society supports efforts to:

    1. Include school based care, workplace wellness programs, group therapies, and increased treatment provided by primary care physicians.
    2. Provide specialty programs for returning war veterans, and their families, that focus on mental health and adjustment to life after military service, in group and individual settings.
    3. Assist patients during the transition from primary care to specialized psychiatric care and supportive therapies as appropriate after initial detection and comprehensive assessment.
  5. Care Coordination and Integration
    Mental illness presents unique challenges to all aspects of health care, and cannot be separated from physical health. The Society supports efforts to:

    1. Integrate and coordinate medical and mental health care within medical clinics, hospitals and schools (consistent with Society policy REQ-007).
    2. Increase access to mental health care for children of all ages. School based mental health services and funding sources for these services should be consistent with AMA policy H-60.991.
  6. Reducing Stigma
    Addressing patient concerns regarding stigma will reduce fear for patients, encourage adherence to treatment plans, and promote the formation of mutually beneficial legislation regarding the disclosure of medical records among health care professionals. The Society supports efforts to:

    1. Use interactive CME modules to educate primary care physicians and specialists in the recognition of stigma related to mental illness. Such education may provide participants with an opportunity to recognize attitudes and behaviors that could contribute to stigma, as well as provide an example of a practical clinical approach to helping doctors and patients overcome stigma.
    2. Educate non-psychiatrist physicians in how to effectively treat patients with mental illness, and make available resources for caring for patients with mental illness. One method would be to implement direct providerto-provider phone connections within health systems to provide psychiatric consultation, and access to counseling services.
    3. Create anti-stigma programs that address stereotypes, prejudice and discrimination in the health care setting.
    4. Encourage all physicians and therapists to talk with their patients about the benefits of medical record access between health care professionals, explaining clearly who receives access to records and how they are used to improve care quality.
  7. Mental Health Parity and Reimbursement for Services
    Mental health parity holds the promise of providing equitable care to patients with mental illness, and must be properly implemented to ensure its success. The Society will:

    1. Actively participate in educating providers in Wisconsin about federal and state mental health parity laws and support the full and proper implementation of mental health parity.
    2. Work to enhance all funding sources for mental health, alcohol and other drug programs, and mental wellness services, and advocate for fair reimbursement for physicians, therapists, and facilities providing these services.(HOD, 0414)