Graham Center: Integrate Mental Health Into Primary Care

Kenneth Lin

Posted 11/14/11 on Common Sense Family Doctor

Based in part on a positive recommendation from the U.S. Preventive Services Task Force, the Centers for Medicare and Medicaid Services recently announced that it will cover annual depression screenings for Medicare patients in primary care settings “that have staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment and follow-up.” However, as the below Figure illustrates, translating the USPSTF guideline into practice has been challenging for many primary care physicians.

Policy One-Pager from researchers at the Robert Graham Center, published in the November 1st issue of American Family Physician, details the obstacles that clinicians face in identifying and treating depression and other mental health problems. As Dr. Robert Phillips and colleagues observe, “Current health care policy makes it difficult for most primary care practices to integrate mental health staff because of insufficient reimbursement, mental health insurance carve-outs, and difficulty of supporting colocated mental health professionals, to name a few.”

On a related note, an editorial in the same issue discusses strategies for improving adult immunization rates, which have historically lagged far behind rates of immunizations in children. According to Dr. Alicia Appel, immunization registries and electronic clinical decision-support systems can complement low-tech interventions such as patient reminders and standing orders. Clinicians, what has been your experience with incorporating depression screening and immunizations into routine health care for adults?

Kenny Lin is a family physician practicing in the DC area. He writes at Common Sense Family Doctor.

Who Shapes Our Personalities?

By Dov Michaeli

Posted 11/14/11 on The Doctor Weighs In

Incredulous Dov

This question was, and still is, the subject of debate among philosophers, neuroscientists and psychologists. Do we have free will?

In that case it is primarily us who shape our own personality. And if neuroscientists’ contention that free will is just an illusion, then what are the factors that contribute to our personality? Not surprisingly, our mothers have a major effect on who we become in later life.

Music’s effect on the baby’s brain

What does music have to do with motherhood? I am using music as a “hook”, as an entréto studies showing the influence of pregnant mothers on the fetus.

Continue reading “Who Shapes Our Personalities?”