Crisis management

Counselors As Contributors to Health Care Reform

The training of counselor educators and supervisors provides for instruction in the wellness model, developmental stages of lifetime adjustment, early intervention and prevention, and empowerment of clients. These values seem perfectly matched for the re-focusing of health care on the early stages of care rather than end-of-life care. An example of a health care model that utilizes early identification of mental health issues and has a client-centered approach to care is Intermountain Healthcare's Mental Health Integration model.

Intermountain's Mental Health Integration involves licensed mental health professionals working side-by-side with primary care physicians. Together they are administering or reviewing clients' mental health screening instruments, consulting with physicians on mental health issues, providing same-day brief counseling and psycho-education, recommending referral for chronic and severe patients, and working in a health care team along with other professionals. This model engages community agencies such as the National Alliance for Mental Illness (NAMI) to support patients and families in the treatment process. Studies at Intermountain indicate that the Mental Health Integration model provides higher quality health care at revenue-neutral or reduced costs. The idea is for mental health workers to collaborate across professional fields to increase quality health care.

The Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders offers the following six aims to achieve high-quality health care:

"The Six Aims of High-Quality Health Care:

• Safe—avoiding injuries to patients from the care that is intended to help them.


• Effective—providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.


• Patient-centered—providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.


• Timely—reducing waits and sometimes harmful delays for both those who receive and those who give care.


• Efficient—avoiding waste, in particular waste of equipment, supplies, ideas, and energy.


• Equitable—providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status"

Source: Institute of Medicine (Eds.). (2006). Improving the quality of health care for mental and substance-use conditions. Washington, DC: The National Academies Press. Retrieved from http://books.nap.edu/openbook.php?record_id=11470&page=57

To prepare for this Discussion:

• Review the article, "Integration of Mental Health into Primary Health care in Uganda: Opportunities and Challenges." Consider the challenges to integrating mental health care into primary care and think about strategies for overcoming these challenges.


• Review the article, "Far West Area Health Service Mental Health Integration Project: Model for Rural Australia," and think about how mental health care can be improved by using a primary health care model.


• Review the article, "Reducing Harm Through Quality Improvement." Consider the challenges and opportunities presented by Intermountain Healthcare's mental health integration quality improvement program.


• Think about how you think the implementation of the mental health integration model might affect you personally.

With these thoughts in mind:

Post by Day 4 an explanation of how you think you would be affected personally by the implementation of the mental heath integration model. Be specific, using the model and your situation to illustrate your points.