Counselors and Physicians Providing Mental Health Services: An Integrated Approach

Abstract

The authors argue that there is a clear link between mental and physical health issues. A wellness-based approach to integrated health care, such as the one described in this article, may allow older clients to be empowered to make lifestyle changes that can improve the quality of their lives and reduce physical illness. ********** Older adults progress through numerous transitions and changes that may require medical and mental health assistance. This segment of the population has the highest rate of suicide and yet are often less likely to seek services from any type of mental health provider than younger adults (Miller, 2005). Treatment for mental health conditions in older adults is compounded by the fact that these individuals may have numerous chronic medical conditions and take a higher number of medications, whose side effects may cause psychological symptoms. Older adults use more medications than any other age group and purchase 40% of prescription medications and 35% of over-the-counter medications in the United States (Correa-de-Araujo, Miller, Banthin, & Trinh, 2005). Medical care has become expensive for Americans. Medical care has become expensive for all Americans and, rather than a house, will be their biggest purchase. Sixty percent of all federal social spending is spent on older adults. This amount is three times more than what taxpayers spend on children. Health care expenses have increased drastically in the past 40 years; these expenses are currently 2.5 times higher than the inflation rate, accounting for 15% of the gross domestic product (Lamm & Blank, 2005). Given the increased spending on health care and other programs for older adults, there is a need to find ways to reduce costs. An integrated wellness-based health care system could assist older adults in living healthier lives, perhaps with a reduced use of medication. Older adults are at high risk for disability and major illnesses (Reicherter & Greene, 2005). Because of the link between physical and mental health, there is a clear need for integrated health care, but the current system has failed to effectively integrate the two systems (Barrels, 2004). Older adults have a higher rate of hospitalization than younger individuals and account for 49% of all hospital days as well as 80% of home care visits (Correa-de-Araujo et al., 2005). Given the projected growth of the older adult population, the spending on health care will probably continue to increase. The number of individuals who are 65 years and older was estimated in 2000 to be 13% of the population and is anticipated to be 25% of the population by the year 2030 (Nunez, Armbruster, Phillips, & Gale, 2003). Along with physical illness, mental illness is also a concern for older adults. The number of older adults who have serious mental health problems is estimated to increase significantly and even double by the year 2030. Higher rates of medical problems are found in individuals who have mental health problems (Bartels, 2004), thus highlighting the need for integrated health care. Individuals are living longer than ever before and, despite advances in medical treatment, are more likely to need medical services (Rosowsky, 2005). With increased life expectancy, there is also an increased probability that older adults will develop chronic conditions that require treatment and lifestyle adjustments (Correa-de-Araujo et al., 2005). Thus, the need for an effective and efficient delivery of integrated wellness-based health care is clear given the growing older adult population. USE OF THE WELLNESS MODEL IN INTEGRATED MENTAL HEALTH CARE Wellness is a lifelong process and is important during every stage of life. Wellness may be even more important for individuals who have chronic medical conditions, such as diabetes, arthritis, and Parkinson's disease. The effects of wellness choices are cumulative and can have a profound impact on the quality of life in later years (Myers, Sweeney, & Witmer, 2000). …