A true medical home includes care for mental health as well as physical

Initiatives undertaken by health-care providers in various states could serve as models for improving mental health services across the country. In Texas, for example, pediatricians, psychiatrists, and family physicians have worked in concert to expand critical mental health services for children, said Stephen Barnett, MD, clinical professor of pediatrics at the University of Texas, who participated in a symposium Friday at the American Academy of Pediatrics national conference in Washington, D.C. The session spent an entire afternoon looking at ways to integrate mental health care into the medical home.

The physicians in Texas have succeeded in getting Medicaid funding for presentations to pediatric and family medicine residency programs around the state; have given a number of continuing medical education programs on mental and behavioral health in primary care settings; and have developed a manual for integrating mental health into primary care. They have also gotten the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment program) reimbursement for exams increased from $48 to $74 and are working with other organizations for legislation to put funding for mental health on parity with that for physical health.

At the same time, the Texas Pediatric Society has established a Mental Health Task Force to deal with mental health issues in offices practices and other settings. With 20% of children in Texas having mental or behavioral problems, said Dr. Barnett, the need for systematic action is obvious.

Featured speaker David Satcher, MD, PhD, former U.S. Surgeon General and interim president of Morehouse School of Medicine, told the symposium, "Mental disorders are as disabling as cancer or heart disease in terms of premature death and lost productivity."

But he also noted that connecting physical and mental care is more important now than in the past because research has increased our ability to recognize, diagnose, and treat conditions effectively. Dr. Satcher said 80% to 90% of mental disorders are treatable with medications or other therapies.