Behavioral Health

Dr. Donlin: In many circles, “behavioral health” and “mental health” are used interchangeably. However, “behavioral health” may also include additional care concerns including behavioral factors in chronic illness management, substance abuse conditions and diagnoses, health maintenance and oversight, etc. One of the most concerning statistics that I recently came across is that a patient with significant medical issues combined with significant mental health issues is likely to have a 25 year shorter life span than the patient without mental health issues. We also know that up to 60% of people attending primary care clinics (according to the World Health Organization) have a diagnosable mental disorder. There may be many reasons for these statistics, but I think it points to the fact that we need to be integrating medical care with behavioral health care in order to best serve our patients.

Dr. Donlin: In many settings, behavioral health services have often been provided in a separate location from medical services.  This “silo” approach to care can contribute to logistical difficulties (for example–adequate access for patients, communication/coordination of care among providers) as well as stigma associated with the care.  In order to provide more efficient, effective, and convenient services to patients, Orange City Area Health System is adopting a model of care in which behavioral health is not only co-located beside primary care providers, but also attempts to provide a truly integrated service in which family practice medical providers and behavioral health providers are working together as part of a collaborative team to best serve the needs of the patient.  The model has been around for a while, and there appears to be increasing evidence that working collaboratively not only provides better outcomes for patients, but can also result in enhanced satisfaction for those providing the care.

Kim: In addition to what Dr. Donlin said above, we know that chronic illness increases the risk of depression, but also the reverse is true: depression increases the risk of certain illnesses (https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health). Mental health cannot be separated from physical health, and for this reason integrating behavioral-mental health services within a primary care clinic is extremely beneficial. Integrated care improves communication between providers, continuity of care, and allows for a team approach while caring for patients suffering from both physical and mental health conditions.

Dr. Donlin: A good number of people are just folks who have experienced significant stressors and are trying to find ways to cope. Sometimes they are demonstrating normal responses to abnormal situations, and sometimes they are dealing with normal situations through abnormal responses. Whether we call these responses depression, anxiety, or something else – the key is to develop healthy coping mechanisms for the stressors they face.

Dr. Donlin: Patients can set up an appointment by calling the clinic number 712-737-2000 and also through referral by their medical provider. Sometimes we even have the opportunity to initiate services during a medical visit, in order for the patient to meet the behavioral health provider and briefly discuss services that could be provided. Confidentiality is always the highest priority for the patient, yet it remains important for the medical provider to be aware of the behavioral needs of the patient and for the behavioral health provider to be aware of the medical issues involved to comprehensively address patient concerns.

Both Dr. Donlin and Kim diagnose and treat mental illnesses, however the types of treatment they offer are different. Dr. Donlin focuses on providing psychotherapy while Kim focuses on prescribing psychiatric medications. The best treatment option varies from person to person and depends the individual’s needs and condition, and some people benefit from a combination of the two. Dr. Donlin and Kim both develop an individualized plan including the best treatment option to fit your needs. If you are unsure where to start (an appointment with Dr. Donlin to begin therapy versus an appointment with Kim for a psychiatric evaluation to discuss medication options), please call the behavioral health department at OCAHS and the team will help determine the best place to start.