Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116654

Ellis Frazier, MD, Family Healthcare Inc., 1049 Western Avenue, Chillicothe, OH 46501, 740-773-4366, mrdatafrazier@yahoo.com

Most primary care providers (PCPs) did not enter the profession expecting enormous fiscal gain; rather, PCPs viewed themselves as philanthropic service givers, especially to the poor and underserved. For some PCPs, reality began in the academic practicum. Poverty, despite lack of current societal acknowledgement, has its own culture transcending race, age, and gender. With less disagreement, poverty correlates with increased rates of morbidity and mortality. Additionally, many diseases are preventable. The research evidence also indicates that these diseases are deeply intertwined with life's other hierarchies – e.g., shelter, food, electricity, and provider access. Although Cleveland and Newark were identified by the Census as the two poorest U.S. cities, poverty is not unique to cities. For decades, Appalachia and the colonias along the U.S.—Mexico Border have been synonymous with poverty. Most PCPs agree when treating individuals needing care, physical and mental health cannot be separate. Most patients with mental health problems are seen initially or continuously by PCPs. However, recent financial and organizational changes in the health care system have created barriers that possibly threaten the therapeutic alliance between PCPs and patients and their families. In essence, integrating mental health into primary care seems totally logical. And, the aforementioned variables require developing collaborative relationships with members of the public health profession and also community representatives. This amalgam is, by definition, transdisciplinary. Almost three decades have passed since similar recommendations emanated from an Institute of Medicine report. This clinician is anxious to have an altruistic realty that operationalizes community-based primary care.

Learning Objectives:

• To describe the populations who seek treatment in primary care centers focusing on behavioral health issues; To identify the barriers, including organizational, regulatory and financing, that impact integrating PCPs and behavioral health providers; and To provide examples of successful integration emphasizing the transciplinary concept.

Keywords: Service Integration, Providers

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF Family Healthcare, Inc..