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Let’s Talk about Mental Health: The Role of Primary Care Physicians in Mental Healthcare Delivery & Management



Throughout the course of the COVID-19 pandemic, the percentage of Americans experiencing symptoms of mental health issues has sharply increased, with adults reporting symptoms of anxiety and depression increasing by a whopping 30.5% since 2019. Just prior to the pandemic, the percentage of U.S. adults reporting symptoms of anxiety or depression sat at 11%, increasing to 36.4% in 2020 and 41.5% in 2021.

Because of the compounding nature of mental health with physical health and social determinants of health, it is not surprising that psychiatric disorder is the number one cause of disability in the United States, with 1 in 5 adults experiencing mental health issues each year. The sheer prevalence of psychiatric burden of illness in the United States, along with its impact on other aspects of health, presents a huge opportunity to improve the health of many Americans.

Mental and physical health have a symbiotic relationship, with one having the ability to improve or worsen the other. Additionally, individuals’ circumstances and environments, such as poverty, food insecurity, and other social determinants of health, have a significant impact on a person’s health. Though mental health issues impact millions of Americans across a variety of different populations, the current state of mental health care is far from equitable. 2020 data in the United States confirmed the alarming disparity in mental health treatment, with only 46.2% of adults with mental illness receiving treatment, and 11% of adults suffering from mental illness without insurance coverage. Furthermore, these disparities in mental health treatment disproportionately impact non-white populations.

See 2020 demographic breakdown of annual treatment rates among U.S. adults with one or more mental illness:

  • 20.8% Non-Hispanic Asian
  • 51.8% Non-Hispanic white
  • 37.1% Non-Hispanic black or African American
  • 43% Non-Hispanic mixed or multiracial 
  • 35.1% Hispanic or Latino  

The inability to access mental health care treatment largely contributes to worsened mental and physical health outcomes for racial and ethnic minorities along with other social determinants of health such as cultural stigma, lack of education, and discrimination. Like most health equity improvement efforts, the success of efforts to address disparities in mental health care will likely rely on engagement with community health stakeholders.

Primary Care Physicians and Mental Health

With the degree of severity and high number of Americans suffering from mental illness, primary care physicians are positioned at the core of mental healthcare delivery. There are roughly 134 million people in the United States that live in a designated Mental Health Professional Shortage Area, and primary care physicians provide over 33% of the care and 25% of the prescribed medications used to treat patients with severe mental illness.  The unique role of a primary care physician throughout a patient’s life provides a significant opportunity for better diagnosis, treatment, and management of patients affected by mental illness. Additionally, mental health and physical health are not independent of each other, with mental illness contributing to greater complexity and cost for many other chronic conditions. Because each individual has their own distinct combination of health conditions and needs, primary care physicians may be the agent of change needed to improve the mental healthcare landscape in the United States. 

Behavioral Health Integrations: Giving PCPs the tools they need to succeed 

Mental health falls under the larger umbrella of behavioral health, which also includes substance use disorders, life stressors and crises, and health behaviors that contribute to an individual’s health and well-being. Research shows that integration of primary and behavioral health care increases access, reduces health disparities, improves treatment outcomes, and minimizes costs. Aside from the issue of the nation’s primary care physician shortage, there are an array of other barriers to achieving behavioral health integrations with primary care. Some of these include political and logistical barriers to leveraging health technologies, such as updating appropriate billing codes for value-based payment models as well as infrastructure to support telehealth, both of which support expansion of access, enable care coordination, and lay the groundwork for integration.

Elation is committed to empowering physicians to deliver high-quality primary care, and this includes advocating for policies that allow primary care physicians to both deliver and coordinate excellent care for patients with mental illnesses. Through Elation’s partnerships with coalitions such as Primary Care for America, we hope to not only provide our customers with tools that help their practices succeed, but make large-scale, positive impacts to the U.S. healthcare system as a whole.

You are not alone.

National Suicide Prevention Lifeline: 1-800-TALK (8255)

Nina Cloven, MHA is Elation’s Manager of Primary Care Advancement. She received her MHA from The John Hopkins Bloomberg School of Public Health and BS in Public Health from Texas A&M University.