A statewide organization of psychiatrists is touting a blueprint to improve mental health treatment and access to care across Illinois.
The Illinois Psychiatric Society has recommended reforms based on three policy pillars: increasing equitable access, improving systems of care, and focusing more attention on preventing mental illness.
“We kind of historically have been dealing with a lot of things from the back end; we're always responding to things, and we thought, ‘well, let's take a proactive approach,’” said Dr. Andrew Lancia of Peoria, the president of the Illinois Psychiatric Society. “So when we took this proactive approach, we wanted to look at three areas where we can make some significant differences.”
Lancia says one of the biggest problems limiting access to treatment is that there just aren't enough psychiatrists.
“It's not just an easy ‘one-done;’ you can't just increase the number of psychiatrists,” he said. “You’ve got to change the system, and that's the whole point of this mental health blueprint: How do we start this conversation so we can implement all these little fixes along the way? In other words, we want to have a say in it and we want our foot in the door so we can help guide it for the betterment of our patients, the betterment of the community, the betterment of the state.”
Lancia says increased use of telemedicine is one way to open more pathways to mental health treatment, but he notes several issues still pose barriers to providing equitable access to care.
“If you don't have enough money for the internet or you don't have access to a computer, that really limits telemedicine,” he said. “So we have to work with legislation (on) how do we expand internet access? How do we expand ways that people can actually have access to that computer, maybe improving libraries? What are some alternative approaches to that?”
Lancia says the prevention pillar ties into the equitable access pillar by encouraging professional help before a mental health problem escalates.
“When we talk about equitable care, we're talking about not only race and sex and all those things. In reality, we're talking about socio-economic status; we're talking about homelessness. We're talking about the spectrum of all the life-environmental issues that people have that cause them issues. If we can address a lot of those issues early on – because childhood trauma, childhood adversities, lead to adulthood problems. So that's where that prevention also comes in is addressing those things. Because if we can do that, we can make much more equitable care for everybody.”
Lancia suggested one solution to the psychiatrist shortage is taking a different approach to providing care.
“One thing that we've talked about for years now is a thing called ‘collaborative care,’ and the collaborative care model is an evidence-based approach to seeing patients. But it does it in a different way that allows us to see a population of patients, not just individual patients. So in other words, we want to change access by changing the way we practice,” said Lancia. “With collaborative care, you actually don't see a psychiatrist; you see your primary care doctor. So that takes away the stigma of going to see a psychiatrist right there.
“We have a behavioral health clinician who's embedded in a primary care clinic. When you see your own doctor, that behavioral health clinician assesses you and then through the information they gather, they will then talk to the psychiatrist and the psychiatrist will formally evaluate you through the behavioral health clinician, through the chart and make some formal recommendations to your primary care doctor. Then your primary care doctor would be the one prescribing medications and treating you.”
