There’s no denying the physical and emotional suffering caused by the COVID-19 pandemic. The increase in suffering also highlighted healthcare disparities as historically marginalized communities were impacted at a higher rate than others. This fact, coupled with public outcry against structural racism and discrimination sparked by George Floyd’s murder, presents us with the challenge of not only improving mental health access but doing so in a way that can improve health and well-being for all communities.
One approach to reaching out to underserved or marginalized communities is the integration of care. The term integrated care is generally used in healthcare systems when we design a system of care in which professionals from a variety of clinical disciplines collaborate and coordinate care to provide patient-centered care. Examples of such efforts in behavioral health care include collaborative care programs that embed behavioral health in primary and specialty care medical practices, and school-based mental health and college mental health programs that bridge the gap between populations at greatest need and the behavioral health services they need most.
However, integration goes beyond embedding behavioral health into medical and school settings.
Integration of clinical care in traditionally non-clinical settings allows us to reach out to communities that may have not benefited as well from the current healthcare delivery models. Healthcare entities need to collaborate with community-based organizations, such as faith-based programs and social service agencies to co-design solutions to do the vital work of culturally appropriate outreach and engagement.
Social determinants
The social determinants of health, such as poverty, lack of transportation, and unstable housing conditions are barriers to care. Another issue in many of our communities is the stigma toward mental illness and substance use disorders. All these factors lead to a considerably lower life expectancy in patients suffering from behavioral health disorders.
At Northwell, the journey with faith-based leaders has included holding forums and town halls, where we listened to the needs of the community instead of bringing a one-size-fits-all approach to care. We’ve learned that in many communities, their faith and mental health are intertwined. That’s an important distinction for how we discuss care, and how we deliver it. The reality is residents trust their community leaders, and we respect that.
When such outreaches are made, faith-based leaders are grateful and enthusiastically support connecting communities with care. This includes linking faith-based organizations with everything from delivering clinical services to behavioral health care coordination to higher levels of care.
This sort of outreach will also combat stigma and eliminate the usual barriers to accessing more traditionally delivered behavioral health services, in part because community members trust their faith-based leaders.
Bringing services to the doorsteps of communities health systems serve is an important step in improving access and building engagement. Here’s hoping that providers continue to integrate, and that will lead to the removal of healthcare inequities, including in behavioral health.