PHILADELPHIA – Penn Medicine received a five-year, $3.7 million grant from the Health Resources and Services Administration (HRSA) to support an academic unit to improve access to treatment for mental health disorders. The grant will establish a new Center for Integrated Behavioral Health in Primary Care in the department of Family Medicine and Community Health at the Perelman School of Medicine, in partnership with the Department of Psychiatry and the School of Nursing. The Center will serve as a national hub to develop, test, and share best practices and enhance training in integrated behavioral health.

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“This funding is timely for addressing unmet mental health needs in the new era of population health,” says project director Chyke A. Doubeni, MD, FRCS, MPH, chair and The Presidential Professor of Family Medicine and Community Health. “We have an epidemic of mental illness in this country and unacceptably large disparities in access to care persist in our communities. Mental health disorder is one of the biggest drivers of low-value care and high healthcare cost in the United States.”

Mental illness is one of the most common chronic conditions and is a major contributor to the overall global burden of disease. Depression is the leading cause of disability in the world. According to the Centers for Disease Control and Prevention, about 8 percent of US adults have depression and Americans make 8.0 million ambulatory care visits primarily for depression each year.

The World Health Organization states that an estimated 350 million people worldwide of all ages suffer from depression and that suicide is the second leading cause of death in 15-29-year-olds. An estimated 31 percent of adults in Philadelphia have a mental health diagnosis. Lack of access to trained health care professionals is a major barrier to receiving optimal treatment for mental health disorders. Integrating behavioral health into primary care is effective at improving access to care by providing services where people normally receive their primary care and allowing for warm handoffs to a mental health care team during the time of a visit with the primary care provider.

Up to one-in-four patients in primary care has depression, but less than one-third of these patients are accurately identified by primary care providers, and many are inadequately treated. Among patients seen in the Department of Family Medicine and Community Health’s ambulatory care practice, about 77 percent of frequent users of the emergency departments have a mental health and/or substance use diagnosis.

“Ensuring that patients have access to mental health care improves outcomes not only in terms of mental illness, but also in terms of other medical outcomes. This cutting edge project can serve as a model for the nation as we work towards integrated care for our patients and psychiatry is poised to be a robust partner in this endeavor,” said Maria A. Oquendo, MD, a professor of Psychiatry at Columbia University Medical Center who will become chair of the department of Psychiatry at Penn on January 1.

The HRSA grant is one of six Primary Care Training and Enhancement program grants nationwide targeting access, quality, and costs of medical care. The Penn site is the only one dedicated to integrative behavioral health. The program will help link academic programs/institutions, practice organizations and other stakeholders through advisory boards to promote the uptake of best practice behavioral health training and care. This project will be implemented under the auspices of the new Center for Community and Population Health (CCPH) in the Department of Family Medicine and Community Health, which focuses on research to reduce health disparities through improved access to care.

Additional faculty on the grant (HRSA-16-041) include Fran Barg; Margaret Baylson; Renée Betancourt; Hillary Bogner; Kent Bream; Peter Cronholm,Melissa Dichter; Anna Doubeni; Heather Klusaritz; Katherine Margo; Richard Neill; David Oslin; Julie Sochalski; and Anne Teitelman.

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