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Experts Anticipate Mental Health, Primary Care Integration

All this week 89.7 NPR News has been looking at the changes in caring for the mentally ill. In recent years, new attitudes, new treatments and even mass marketing have more people seeking help for depression and other conditions. In part three, WOSU’ reports the coming years should see even more access to mental health services. A group of women follow the lead of 46-year-old Traci Parks, who holds a unique certification. She’s a certified laughter leader. Parks gives talks on how laughter is an integral to good health. In this session, Parks has talked them into jumping around for an “ants in your pantsâ€? laughter exercise. The women hop around, wiggling and giggling. For Parks, laughter may not be the best medicine, but it’s at least a medicine. Watching her, you’d never suspect Parks has spent 20 years coping with severe depression. Park’s has been hospitalized three times. She’ll likely take medication for the rest of her life. “My brain chemistry’s broken. I need a brain chemistry transplant, and they don’t do those yet," she joked. It took years and countless doctors appointments for Parks to find the right combination of medications. The system, said Parks, does not make it easy for the chronically depressed looking to find a psychiatrist. “You can’t find one. And if you find one, they may not take your insurance. Or if you’re not insured, it’s $150 for one session," she said. "And you aren’t going to get meds in one session. You’re not going to figure out the core reason for your depression in one session. So people either can’t afford it or they’re not available.â€? There’s a shortage of psychiatrists said Ohio Department of Mental Health’s medical director Mark Hurst. “We’re at a point right now where we’re not even replenishing the supply of psychiatrists that are retiring. And there is an increasing need of psychiatrists due to increasing prevalence of mental illness," Hurst said. And with the expansion of health care under the Affordable Care Act, wait times to see a psychiatrist could grow. So here’s what’s in store for the future: psychiatry and general medicine are expected to be more integrated. It’s already happening. Traci Parks gets her medications from her primary care physician. A practice that’s becoming increasingly popular as primary care docs become more familiar with psychiatric drugs. Dr. Hurst predicts as the federal health care law rolls out, general practitioners and psychiatrists will collaborate more, even share offices. “If I see my primary care doctor and he notes that I'm a little bit depressed, and says, ‘gosh, what I’d really like for you to do is go down the hall and talk to my colleague in psychiatry here’, that decreases stigma; that improves access. It normalizes a mental health treatment approach.â€? Increased access to doctors is especially important for young people suffering from mental illness. Some medical professional hope greater access will prevent violence. Ohio State University Harding Hospital executive director Amanda Lucas said young adults, 16 to 25-year-olds, are in what she calls a “transition age.â€? “That’s also the time, if somebody is at risk, where they are most likely to have a first break psychotic episode," Lucas said. Lucas stresses most people with a mental health disorder do not become violent. But high-profile cases, like the Aurora, Colorado theater shooting last July, highlight a need for mental health treatment. The shooter has pleaded not guilty by reason of insanity. But Lucas said with the new health care law more young people are able to stay on their parent’s insurance and more importantly, stay on their medication. “That will sort of in a preventive mode allow us to continue treating that person.â€? Still, the experts agree the vast majority of people with mental illness get no help at all.