26 MARCH 9 - MARCH 15, 2018 BROOKLYN MEDIA GROUP
Co-locating primary care and behavioral health
shows marked improvement in life expectancy
In an effort to improve health outcomes
for patients with serious
mental illness (SMI), practitioners
at the Family Health Centers at NYU
Langone have developed an innovative
model that adds primary care
assessments in the behavioral health
setting.
“We are redesigning the way patients
experience care and integrating
a multidisciplinary team of providers
that includes primary care physicians,
psychiatrists, psychologists,
social workers, nurse practitioners,
and others,” said Jon Marrelli, PsyD,
program manager, behavioral health
and primary care integration. “We
are helping patients improve their
overall health by inspiring them to be
knowledgeable and fully engaged in
their own care.”
“For years, mental illness was treated
as if the head were not connected to the
body and its medical conditions. Providing
for the needs of the whole patient
is the prudent approach,” said Larry
McReynolds, executive director of
Family Health Centers at NYU Langone.
Patients with SMI often suffer at
much higher rates from high blood
pressure, high cholesterol, obesity
and elevated blood sugar levels, as
well as side effects from smoking and
substance abuse.These health indicators,
collectively known as metabolic
syndrome, can increase the risk of
heart disease, stroke, and diabetes.
As a result, life expectancy for those
suffering from SMI is up to 20 years
shorter than the general population.
“A variety of risk factors and adverse
effects, including a sedentary
lifestyle, low self-confidence, and inattention
to personal health, contribute
to a shorter life expectancy,” added
Marrelli.
In 2014, the Family Health Centers
at NYU Langone (FHC) received a
four-year, $1.7 million grant from the
Federal Substance Abuse and Mental
Health Services Administration to
develop a primary care assessment
model in a behavioral health setting.
FHC cares for approximately 3,000
patients each year who experience
serious mental health problems, including
depression, anxiety, bipolar
disorder and schizophrenia.
HOW IT WORKS
The program, called STIR (Sunset
Terrace Integration and Recovery),
requires a 12-month commitment and
encourages patients to increase their
health literacy, take an active role in
their care and get to know their team
of providers. Patients complete a questionnaire
to screen for potential health
conditions, smoking, and other risk
factors, and receive a variety of health
assessments. They are enrolled in educational
classes that cover healthy
living and eating, tobacco use, and
managing the emotional consequences
of depression, anxiety, panic, and
other conditions. A certified tobacco
specialist helps patients reduce or quit
smoking while a navigator helps them
overcome potential barriers to care.
According to Marrelli, 213 patients
who have completed the program had
statistically significant improvements:
decreases in blood pressure, improved
cholesterol levels and decreases in
waist circumference, a measure of
obesity.
One particular success story was
an individual who lost 40 pounds,
accompanied by significant decreases
in total cholesterol and decreased
triglycerides. The patient credits the
team approach to health monitoring
and the educational programming
where he learned to manage his
condition.
“Patients are so proud of what they
have accomplished in improving their
health that many ask to extend their
participation in the program,” said
Marrelli.
For more information about the
Family Health Centers at NYU Langone
STIR program, call (718) 431-2637.
“For years, mental illness was
treated as if the head were not
connected to the body and its
medical conditions.”
— Larry McReynolds, executive
director of Family Health Centers at
NYU Langone
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