Tens of millions of Americans who live with mental illness also suffer from a serious co-occurring physical condition. Because of this, many people with persistent mental illness die as much as 25 years earlier than the rest of the population, according to national studies. The research clearly demonstrates that such early deaths are, for the vast majority of these people, directly related to their poor physical health.

When physical disorders such as obesity, heart disease and diabetes are not addressed with the mentally ill, the consequences can be fatal and carry a huge cost burden.

But the majority of people who are diagnosed with both mental illness and substance abuse disorders do not receive any treatment at all for their comorbid (simultaneous) conditions, according to national surveys on health and disease. They also often live in poverty, cycling in and out of homeless shelters, jails and emergency rooms, worsening their health.

This leads to a larger question facing health care providers today: How much is the absence of effective whole-person care management costing everyone? During this era of Obamacare and the rising cost of health care, a dramatic change in how we deliver health care is imperative.

Maine Behavioral Healthcare, which includes Spring Harbor Hospital, southern Maine’s only nonprofit hospital for in-patient psychiatric care, recently received a large donation from a local philanthropist to fund the idea of treating mental health needs through a holistic approach.

This gift will not only provide training for clinical staff in the co-occurring disorders of mental illness and substance use issues, but also will ensure a consistent approach. Moreover, it forces us to consider the idea of meeting our health needs by examining closely the mind-body connection


Bringing together the disparate systems of mental health and primary care is gaining traction for obvious reasons. When you begin to understand how mental illness can affect physical illness, you can not only improve successful treatment and outcomes, but also cut costs dramatically.

Take, for instance, the statistic in the November 2008 American Journal of Medicine that people with diabetes and depression have four times the health care expenditures compared to those with diabetes alone.

On the flip side, people with prevalent physical conditions like lower back pain, heart disease, diabetes and asthma can have a simultaneous psychiatric condition — often depression. When you’re a person with a co-occurring physical disorder, the difficulty of navigating a fragmented system of care is compounded. An integrated treatment program, however, can provide answers by combining interventions that address both mental illness problems and physical health issues.

This is the same idea behind Maine’s Behavioral Health Home model, initiated this past spring by MaineCare Services, an office of the state’s Department of Health and Human Services.

A Behavioral Health Home is not a place but a concept: a team of professionals coming together to treat the whole person. The team is composed of a case manager, peer support specialist, nurse care manager, medical and psychiatric consultants — all collaborating. This shared decision-making to treat the emotional, social and physical needs of the patient holds the promise of improving the experience of care and health outcomes while reducing costs.

Maine Behavioral Health care also recently received a $1.6 million federal grant to integrate primary care providers within its mental health sites in Biddeford and Springvale to improve health outcomes and the experience of care for adults with serious mental illness.


The focus population is adults with both serious mental illness and chronic physical health conditions, specifically a substance abuse disorder, asthma, diabetes, heart disease, hypertension and obesity. The project is a “reverse” or “full-spectrum” integration initiative because it brings primary care providers into a behavioral health practice instead of the more typical practice of placing mental health providers in a primary care setting.

Merging care for the brain and the rest of the body not only provides better care, increasing the quality and length of human life, but also reduces costs by addressing all of the patient’s needs.

Ignoring the overwhelming statistics in poor health outcomes is irresponsible. In a time of critically rising health costs, we need a new model for health care — one that values quality over quantity, and whole person care over partial care, to achieve better outcomes while saving all of us money. There is no better time than now to be mindful of the importance of whole-person treatment for the improved health care of generations to come.

Dennis P. King is president and CEO of Maine Behavioral Healthcare, which is based in South Portland.

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