Coordinating Care for Better Mental, Substance Use, and General Health Benjamin G. Druss MD, MPH June 26, 2006

Two Issues Central to the Committees Work and Findings Mental, substance-use, and general health conditions commonly run together However there is separation across the systems that treat them and fragmentation within them.

Overarching Recommendation Health care for general, mental, and substance-use problems and illnesses must be delivered with an understanding of the inherent interactions between the mind/brain and the rest of the body.

Some Key Terms Collaboration: Communication, shared understanding of goals, shared decision making Care Coordination: The outcome of effective collaboration Communication: Clinicians share needed information with other providers

Finding A Balance Communication: Information Sharing vs. Privacy Coordination: Centralization vs. Specialization Collaboration: Shared vs. individual accountability

(1) formal agreements (2) case management (3) collocation (4) coordinated practices of primary and M/SU care providers. A Continuum of Coordination Less coordination More coordination Organizations should seek to move towards greater coordination between MH/SU and primary care:

Who Needs to Be Involved Clinicians and Health Plans Purchasers Accreditation agencies Federal and state governments

Bottom Line Need to foster improved communication, with an eye towards protecting patient privacy Need to foster improved collaboration and coordination, while retaining MH/SU expertise Need to identify someone who is accountable, while also recognizing we all are accountable