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    Thomas R. Young
    Thomas R. Young, MD

    America is in the midst of a mental health crisis. According to a 2023 State of Mental Health in America survey, more than one-fifth of US adults — totaling more than 50 million people — are experiencing at least one mental health illness, while 12.1 million adults have reported “serious thoughts of suicide.”

    Teenagers and adolescents are similarly struggling. U.S. Surgeon General Vivek Murthy has issued several startling warnings about the “devastating effects” and worsening state of young people’s mental health. This reality is perhaps best illustrated by a tragic 40% increase in youth suicide rates and an 88% increase in emergency room visits for self-harm over the past two decades.

    Fortunately, it’s not all bad news.

    While people can’t will themselves to better mental health outcomes, treatment works, and the number of Americans seeking mental health treatment has doubled in the past 20 years.

    However, to improve impact and help as many people as possible, we can’t wait for them to seek support. We need to proactively screen for mental health conditions early and often, identify people who need help and connect them with resources that can help them thrive.

    The healthcare sector already understands the benefits of preventative screening for physical health conditions. From vision and hearing to spine development and blood pressure, early screening is common and effective, hastening treatment opportunities and allowing healthcare professionals to put people on a path to recovery as quickly as possible.

    Now, we need to bring that same process and approach to mental health screenings, integrating them into the standard well-check process.

    Challenges faced by primary care providers (PCPs) in the United States

    Understandably, many healthcare providers feel unprepared and unequipped to integrate mental health support into their existing patient care efforts.

    This has been a decades-long problem for the healthcare sector generally and frontline workers specifically. In the 1970s, the United States shifted from mental health institutions to incorporating mental health into existing healthcare systems. This made PCPs the backstop for mental health, even without adequate training or resources.

    Today, PCPs comprise up to 85% of all diagnoses, including those for mental health disorders, and write a majority of prescriptions for mental health drugs. Even though they are at the forefront of mental health care, PCPs frequently face a lack of support, training and reimbursement.

    At the same time, connecting patients with the right support systems can be especially difficult as a shortage of mental health professionals, such as psychiatrists and therapists, prevents people from attaining the care they need.

    The deficit is staggering. The U.S. Department of Health & Human Services expects a shortage of 10,000 mental health professionals by 2025, and the Kaiser Family Foundation estimates that 47% of the U.S. population lives in a mental health workforce shortage area, severely constraining the number of people with access to solutions that work. 

    Collectively, medical practices struggle with integrating mental health care due to lack of remuneration, collaboration, technology, and tools for assessment and tracking outcomes.

    How to support positive patient outcomes

    These challenges are real, but they can’t stop us from providing patients with the mental health care they need and deserve. With the right approach, practices can catch mental health issues early, improving outcomes across the board.

    Here are three ways most medical practices can begin that process now.

    1. Enable early diagnosis and treatment

    Early intervention is key to minimizing harm and maximizing treatment opportunities for patients with various mental health maladies.

    The effects of early intervention can be expansive and far-reaching. For example, as one analysis explains, “Anxiety often develops early in childhood and adolescence, and is easily recognized and treated. Left untreated, anxiety can lead to the onset of other mental illnesses or reduced educational or career achievement.”

    Implementing screening tools, developing identification processes, and accepting referrals, are all steps practices can take to make this priority a reality.

    2. Conducting age-appropriate psychiatric assessments

    Age-appropriate psychiatric assessments are essential in understanding mental health challenges specific to different stages of life. Children, adolescents, adults and the elderly will often manifest different symptoms for the same mental disorders, and the way they express their feelings or emotions can be vastly different.

    This might include encouraging expressiveness in different age groups:

    • Children: Encouraging children to express their feelings through drawings or stories can help them articulate their mental state.
    • Adolescents: Building trust and relating to their unique experiences can make adolescents more open to sharing.
    • Adults: Offering confidential and non-judgmental spaces for adults to talk can foster openness.
    • Elderly: Encouraging reminiscence and validating their life experiences can make the elderly more comfortable expressing their feelings.

    Simply put, by tailoring psychiatric assessments to each age group and encouraging open and routine discussions about mental health, healthcare providers can not only diagnose more accurately but also promote a culture where mental health care is accessible, accepted, and understood.

    3. Performing measurement-based care

    Performing measurement-based care in mental health treatment is as crucial as in physical conditions, necessitating tracking and objective measures to ensure quality care.

    Regular monitoring and standardized tools allow for early diagnosis of severe mental illnesses and customized treatment plans, potentially changing life trajectories and preventing relatively minor mental health challenges from becoming major life obstacles.

    By applying the same diligence in tracking mental health as with physical health, healthcare providers can offer more effective care and improved overall health outcomes. This unified approach reinforces the profound interconnectedness of mental and physical well-being, helping practices support their patients more completely and effectively than ever before.

    Practices can’t do it alone

    As America’s mental health crisis continues to surge, innovations in technology and treatment have improved access to mental health care. Yet, despite these advances, a crucial element is still missing: Early screening for mental health challenges for the general population of children and adolescents to adults as patients in the offices of their most frequently seen healthcare provider: their PCP’s medical practice.

    While progress has been made, with more people seeking treatment than ever before, the onus can't solely rest on medical practices.

    The challenge of integrating mental health care into the primary healthcare system is multifaceted and requires a collective effort. It calls for early and regular screening, tailored psychiatric assessments, digital solutions, and an approach recognizing the intrinsic link between mental and physical health.

    Only through this united effort can we foster an environment where mental health care is accessible, accepted, and understood, ensuring that no individual faces these challenges alone.

    In the middle of a crisis, that’s hope enough to keep working together to cultivate care solutions that meet the needs of every patient who shows up at our practices.

    Thomas R. Young

    Written By

    Thomas R. Young, MD

    Thomas R. Young, MD is a board-certified family physician with more than 35 years of medical experience. He is also a recognized thought leader on ways to better identify and manage mental health disorders, especially among adolescents and teens.

    Dr. Young currently serves as the Medical Director for Port of Hope in Nampa, ID, where he provides psychiatric services for clients with substance use disorders and co-occurring mental health disorders. Dr. Young is also the Founder and Chief Medical Officer of Proem Behavioral Health, formerly nView Health, developer of the evidence-based clinical workflow software engine that helps providers triage patients and produce better mental health outcomes.

    Dr. Young also served as President of Behavioral Imaging Solutions, a technology firm recognized for its application of video imaging for the treatment of children with autism. Most recently, he served as Chief Operating Officer at US Preventive Medicine, a health technology leader in Population Health Management.

    He is also a successful entrepreneur. His business ventures include Diversified Franchises, LLC which owns a chain of specialty restaurants, a home health business, and Elite Sports Society, a successful sports marketing business where he serves as the business development officer.

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