Integration Effective for Co-Occurring Chronic Disease and Mental Disorders



In Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment, published in the October 2014 issue of Preventing Chronic Disease, the comorbid nature of chronic disease and mental disorders is examined. In the United States, the number of people with multiple chronic conditions, including mental health disorders, is increasing. Almost half of the population lives with at least 1 chronic disease (e.g., cardiovascular disease, diabetes), and 7 out of 10 deaths occur because of these diseases. In addition, “1 in 4 Americans aged 18 years or older will experience a diagnosable mental disorder in any given year [and] nearly half will experience a mental health disorder in their lifetimes.”  

Medical professionals want to understand how mental health disorders affect other health conditions and overall health. Recently, the wars in Iraq and Afghanistan of the past 10 years have spurred this interest since military populations experience mental health symptoms associated with chronic disease.

Since mental health conditions “are likely influenced by chronic disease diagnosis and maintenance,” the increasing burden of chronic disease must be understood in the context of mental disorders. Two previous Institute of Medicine (IOM) reports, Crossing the Quality Chasm: A New Health System for the 21st Century and Improving the Quality of Health Care for Mental and Substance-Use Conditions, call for integrating behavioral health and primary care services to better address mental health and comorbid conditions.

The U.S. Veterans Health Administration and many university health services have adopted integrated health care and demonstrated “both clinical improvements and financial benefits.” The Centers for Disease Control and Prevention’s (CDC’s) National Center for Chronic Disease Prevention and Health Promotion developed the Public Health Action Plan to Integrate Mental Health Promotion and Mental Illness Prevention with Chronic Disease Prevention, 2001-2015. This document proposed “increased surveillance of mental health and chronic and chronic disease measures” as well as epidemiology and prevention research, and more communication between health professionals and the general public.

Ultimately, “a continuum of care that integrates all aspects of health care” will be required to better comprehend disease comorbidities and risk factors. Integrated behavioral health and primary care will indeed help us“to understand the relationship between these health concerns which are often clinically disconnected.” Integration will result in better diagnosis, treatment, and prevention of mental disorders, leading to improved treatment and a reduction in treatment cost.

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