New Jersey Department of Health

PO Box 360
Trenton, NJ 08625-0360

For Release:
July 26, 2017

Cathleen D. Bennett

For Further Information Contact:
Office of Communications
(609) 984-7160

Op-ed: Integration of Mental, Physical and Behavioral Health Care Is Right for Patients

Cathleen D. Bennett, Commissioner
New Jersey Department of Health

In testimony submitted to a joint legislative committee this week, I outlined the Christie Administration’s goal to create a patient-centered system of care that would treat the “whole person” in the same setting and no longer cordon off mental and behavioral services from the rest of medical care.

Mental and substance use disorder health care should not be treated any differently than chronic diseases like diabetes or heart disease, although, at times, the health care providers may be different.

Helping healthy New Jerseyans stay well, preventing those individuals at risk from getting sick, and keeping those individuals with chronic health conditions from becoming sicker — what we call Population Health — is a key focus not only for the New Jersey Department of Health, but also for our health care and community partners around the State.

Considering one of the main missions of the Department is Population Health, it is impossible to meet the needs of all New Jerseyans by focusing only on their physical health. Mental illness and addictions can influence the onset, progression and outcome of other illnesses and often correlates with health risk behaviors. The Centers for Disease Control and Prevention (CDC) estimates that half of American adults will develop a mental illness during their lifetime, that in any given year, 25 percent of American adults experience a mental disorder, and that 1 in 17 American adults lives with a serious mental illness. A CDC report found chronic diseases including diabetes, obesity and cardiac disease are associated with mental illness.

Similarly, people who suffer from addiction also tend to have one or more co-occurring health issues — chronic diseases, infectious diseases or mental disorders. A public health crisis in Indiana serves as a recent example of how addiction can lead to further illness.  An increase in injection of opioids caused HIV and hepatitis outbreaks in rural Indiana in 2015, leading their Governor to declare a public health emergency. Health experts predict the lifetime cost of treatment for those individuals impacted could reach $58 million. Likewise, ensuring that pregnant women who use substances find the help they need to deliver a healthy baby is another critical area where physical and behavioral health care intersect.

Many frequent users of Emergency Departments have behavioral health conditions. Appropriate, community-based care of their total health needs can reduce reliance on expensive hospital-based care, according to a 2016 study by Seton Hall Law School.

The transition to designate the Department of Health as the single state agency to perform the administrative and operational functions of mental health and addiction services will expedite the important integration of physical, mental and addictions health management. As the state’s public health agency, the Department can identify risk factors, increase awareness about behavioral health and the effectiveness of treatment, reduce health disparities, and remove the stigma that prevents people from seeking and receiving the care they need.

In rural Tennessee, Cherokee Health Systems has become a national model for integrating primary care and behavioral health services at 22 Federally Qualified Health Care Center sites. A behavioral health care team is embedded in its primary care practice, and its success has been recognized by the U.S. Agency for Healthcare Research and Quality. A study of Cherokee’s interdisciplinary team approach by Blue Cross and Blue Shield of Tennessee found a 68 percent decrease in emergency room visits, a 32 percent decrease in referrals to specialists and an overall 22 percent reduction in cost.

Recognizing the need for better integration, we have already granted a waiver allowing community health centers licensed by the Department to add behavioral health in shared clinical space.  This reorganization will allow us to take the next steps to ensure the on-going integration of care.

There is no question that the task ahead is challenging, and we understand the concerns that have been articulated. But this reorganization is the first step in advancing a new system of integrated care. As part of this transition, the Department will gain the expertise of the management team and staff who work in and supervise the psychiatric hospitals and oversee hundreds of mental health and substance use disorder contracts. This expertise will add to the Department’s long history of distributing $1.5 billion in community grants annually.

Creating a more efficient and coordinated system that treats the whole person is the right move for New Jersey and especially for patients who will benefit from having their behavioral and physical needs met in the same hospital clinic or community health center.