If the mind and body are one thing, then health care for the mind and body should become one thing. Yet huge walls separate physical heath care and behavioral health care, according to experts and scholars. If it were not tragic, it would be funny. Is my mental health threatened if I laugh while crying?
Dr. Gail Stuart described a Keystone Cops-like attempt to integrate physical health and behavioral health in primary care. Care providers set goals and standards. Doctors wrote down what they did. Behavioral health providers wrote down what they did. Perfect silos! So they went back and tried to blend the two.
Doctors wrote what behavioral care providers should do. Behavioral care providers wrote what doctors should do. Perfect silos, perfectly swapped. “It’s still hard to get out of silos—because the medical model holds on—it’s not holistic,” said Stuart.
Stuart was speaking at the Carter Center in Atlanta. It was the 31st annual Rosalynn Carter Symposium on Mental Health Policy, held Nov. 12–13. Stuart is a nurse. She is dean of the College of Nursing and a distinguished professor at the Medical University of South Carolina. The name of this year’s symposium was “Help Wanted: Reshaping the Behavioral Health Workforce.” Nurses are a cure for the silos between mental and physical health care, according to Stuart. “Nurses already care for the whole person.”
America has 6.8 million nurses who are potential behavioral health providers, according to Stuart. If they assessed people’s behavioral health needs, trained lay providers, gave support, and made referrals, it would make a difference. The difference would be physical as well as mental. For example, said Stuart, “Lay community workers, trained by nurses, reduced amputations from diabetes by 50 percent.” That was a behavioral health care intervention, led by nurses.
