In 1974, music critic Jonathan Landau penned a classic article in which he stated, “I have seen the future of rock and roll and its name is Bruce Springsteen.” Landau was commenting on his impression of the debut album of the then-fledgling rock star. If you will permit my imaginative analogy, I believe that the same can be said about the collaborative care model with respect to the future of psychiatry. For this reason I invited Jürgen Unützer to co-author this column for Psychiatric News.
With the enactment of the Affordable Care Act, the rise of accountable care organizations and patient-centered medical homes, and the increased national attention on mental health, psychiatrists and primary care providers have an unprecedented opportunity to join together and work collaboratively on increasing the overall health of millions of Americans. APA recognizes this opportunity and has been actively involved in efforts to improve integration and collaboration with our primary care colleagues.
As one of the largest medical specialties, psychiatry is an important component of the physician workforce in the United States, but psychiatrists are distributed unequally around the country. More than half of the counties in the United States don’t have a single practicing psychiatrist. Only about 1 in 10 adults with a diagnosable mental disorder receives care from a psychiatrist in any given year and patients are much more likely to receive mental health treatment from their primary care provider than from a psychiatrist. It is well known and often said that 40 percent of primary care (adult and pediatric) involves dealing with psychiatric problems. Our colleagues in primary care are well aware of the substantial challenges related to treating the millions of patients who present with mental health problems in their offices every year and report serious limitations in the support they receive from psychiatrists and other mental health specialists.
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