The roadblocks to integrating behavioral health into wider care are the same as those that stand as barriers to other sorts of integrated care efforts: mainly, a lack of funding and insufficient coordination among care specialties. SAMHSA estimates that mental health treatment spending as a share of overall healthcare spending in the U.S. will fall from its 2009 level of 7.4 percent to just 6.5 percent in 2020.
"Many healthcare providers, specifically primary care doctors, may feel they just don't have time to assess the mental health of their patients," said Sally Dunn, MSW, clinical director of education at naviHealth, a Cardinal Health company. But Dunn, a licensed social worker who previously worked in an outpatient mental healthcare center and maximum security forensic hospital, said primary care doctors can often be a first line of defense in addressing mental health issues.
Additionally, medical doctors often feel ill-prepared to treat mental disorders. Garner, a practicing pediatrician who also served as chair of the American Academy of Pediatrics' Leadership Workgroup on Early Brain and Child Development, said that when your job is to heal people, taking on an illness outside of your skill set can lead to frustration and burn out. The solution, he added, is to train physicians to ask the right questions so that they can refer patients to mental health professionals as needed. Instead of simply asking, "How do you feel?" a physician could ask, "How can I better understand what you are going through?" This approach will help patients identify more adaptive and healthier ways to cope, as well as additional resources.