March is National Disability Awareness Month. Approximately 61 million Americans are living with a disability. The term “disability” is defined in various ways but for the purposes of federal disability nondiscrimination laws (such as the Americans with Disabilities Act), the definition of a person with a disability is typically defined as someone who “has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment.” This can include physical or mobility impairments, cognitive or developmental disabilities, or sensory impairments such as blindness or deafness. Despite the historic passage of the Americans with Disabilities Act in 1990, people with disabilities continue to face discrimination and unequal access to healthcare.
Barriers to Health Care
Health disparities among people with disabilities are well documented. Adults with disabilities are almost twice as likely to report unmet health care needs due to barriers they face in accessing care. Health disparities may result from multiple barriers to care such as:
- Stigma and discrimination by health service providers with limited knowledge or understanding of those living with a disability
- Health services and locations that are inaccessible, including passageways, doorways, restrooms, and exam rooms with fixed-height furniture
- Health information may not be provided in an accessible format, making it difficult for those with disabilities to be involved in the decision-making process
- Costs associated with traveling to and from a health service and paying for medicine, let alone the cost of seeing a provider or multiple providers
Additionally, for many people living with disabilities, physical care is seen as the first priority. But when a disability impacts a person’s quality of life, it can have a direct effect on all aspects of their well-being and daily experiences. Physicians may overlook mental health symptoms or dismiss them as byproducts of the physical experience, leaving a reported one-third of people with disabilities living with behavioral health issues to figure it out themselves.
Finding the Right Team for Your Needs
If you are living with a disability, then it’s important to have as much information as possible so you can navigate both physical and health care effectively. When searching for a care team, look for providers who are willing to help you explore potential options. Ask questions such as:
- What do you think might be causing my mental health symptoms?
- Could my physical conditions be impacting my mental health?
- What assessments can we conduct to better understand the problem?
- What type of specialist do you think I should see?
- Do you have any mental health providers you can recommend who have experience treating individuals with disabilities? What accommodations can they offer?
Even with all the information you need, you may still face barriers of inconvenience that prevent you from receiving optimal care. It’s true that current models of care delivery are not always well suited to addressing the needs of those living with a disability, and it can take anywhere from a few weeks to months to find proper treatment due to inconsistent communication between providers.
Clearly, the current fragmented healthcare system is inefficient and is having a negative impact on patients’ quality of life. By reducing the fragmentation between behavioral and physical health services, we can produce better health outcomes and diagnoses. Enter: integrated care.
Effectively Integrating Care for All Populations
As doctors and mental health professionals, it is our job to dig deeper and address the core issues that keep people from living life to their fullest. Whether that’s uncovering childhood trauma that hasn’t been addressed or substance use that helps numb overwhelming symptoms, addressing “one side” of a person’s care is just the tip of the iceberg.
Integrated health care has the potential to help people address their mental health needs in a primary care setting. By bringing together a team of doctors, nurses, social workers, and therapists together, integrated care can normalize and de-stigmatize mental health treatment and ensure all of a patient’s health needs are met holistically. Even further, we need an integrated system that puts the patient at the center: where individuals participate in their treatment with respectful health care providers.
The Benefits of Integrated Care at Sage
At Sage Neuroscience Center, we treat each individual as a whole person, not a diagnosis or condition, and our multidisciplinary team responds to your physical and clinical needs while considering your emotional social, intellectual, and spiritual needs.
- Addressing Stigma: Some people may hesitate to raise their mental health needs with a primary care provider, and that hesitance can delay treatment. Our Primary Care providers ask about your feelings of stress, anxiety, depression, and substance use as part of the standard routine check-up to help normalize and de-stigmatize mental health symptoms and the corresponding treatment.
- Offering Person-Centered Care: When symptoms are identified earlier, treatment can begin sooner. At Sage, our providers will work closely with you to identify symptoms and areas of need to create a customized treatment plan with our multidisciplinary team.
- Accessing Care: All of our services are performed in one location (with interpretive services provided when needed) and many can be offered virtually. Our in-house pharmacy allows you to pick up your prescriptions right after your visit – or have them mailed directly to your door. Finally, many of our providers accept Medicaid, including within our Counseling Intern Clinic.
- Preventing Physical Health Conditions: Sadly, people with serious mental illness die earlier than their peers without mental illness. The vast majority of these deaths are due to chronic physical conditions such as cardiovascular, respiratory and infectious diseases, diabetes, and hypertension. Mental health care integration has the potential to help address the physical health needs of people with mental illness by encouraging people to receive preventative care while treating their mental illness.
While individuals with disabilities may have different needs, the quality of care they receive should not change. Sage believes that all people with mental health conditions deserve accessible, affordable, and comprehensive healthcare. Listening to a patient’s every symptom and working to understand the patients’ needs and experiences is essential to increasing access to care, improving the quality of care, and addressing health disparities for people with disabilities.