In looking at an agency through integrated health lenses, it can be a bit obvious why engagement in wellness is a challenge. Successful integrated healthcare approaches can only emerge from a highly-committed agency and workforce, and getting an agency to walk the talk of integration can be its most significant challenge.
The first step to becoming an integrated system of healthcare is to assess your agency’s day to day practices. This culture involves not only a physical environment and treatment services but also the verbal and nonverbal cues coming from employees. You don’t see a soda machine in a dental office or a candy bowl in a health club because these actions are incongruent to the business’s core message. Within a behavioral health agency, the culture can often send a message of poor health habits like the use of tobacco and availability of junk food.
An agency with a physical environment supporting an integrated health culture includes the following:
In America, 44.3% of all cigarettes are consumed by individuals who live with mental illness and/or substance abuse disorders, according to the National Alliance on Mental Illness. Stopping smoking can be a struggle for anyone, but mental health agencies often feel conflicted about having a smoke-free campus, citing concerns about coming off as unwelcoming. The ambivalence of smoking on the part of behavioral health staff can be a barrier, even when county and state level policies require a smoke-free campus. Supporting a smoke-free environment through the use of toolkits can be an excellent first step. A great example is a comprehensive toolkit developed by the University of Colorado Anschutz Medical Campus School of Medicine.
Vending machines, sugar-laden meeting snacks and waiting room coffee pots contradict the wellness programming offered as part of services. A good start is to make it policy that any food or drink provided or sold at the facility must support good health, for both staff and patients.
Waiting rooms and treatment areas that have media and literature supporting good health can build a foundation for people who might be less engaged in working on health goals. Successful integrated care programs often start with people watching short videos, like these examples from The Blissful Mind, or reading a pamphlet on health conditions while waiting for an appointment.
When asked about joining a wellness group or to become involved in health education, people may often decline due to ambivalence, lack of time, or not seeing it as a high need, especially if the activity is seen as an extra appointment. When wellness activities are embedded in clinical practices, rather than a separate health service program, people become engaged in maintaining their health as a natural part of managing their behavioral health needs, which really is how integrated healthcare should be.
Too often, staff providing behavioral health treatment have difficulty practicing good health habits including eating healthy, exercising and taking breaks – some of the very activities recommended for people receiving services. Creating a work environment that supports good health is vital in creating a culture that walks the talk of integrated healthcare. SAMHSA-HRSA Center for Integrated Health Solutions (SAMHSA-HRSA) offers online resources to help workplaces get started.
As part of its Integrated Healthcare initiative, a new self-assessment tool has been developed by the SAMHSA-HRSA to help workplaces begin the process of creating a culture that walks the talk of health. As organizations take steps to develop a system that supports good health, taking a close look at the agency’s culture is a crucial step successfully implementing an integrated system.
Kathy Polasky-Dettling, MA, is the director of Clinical Services at Afia, and a consultant with the National Council for Behavioral Health and the SAMHSA-HRSA Center for Integrated Health Solutions. Polasky-Dettling specializes in agency readiness assessments, developing integrated care strategies, and coordinating multi-year state and county learning communities. She has worked in community mental health centers for more than 25 years and holds a Master’s degree in counseling psychology from Western Michigan University and a certificate in primary care and behavioral health from the University of Massachusetts.All Thought Leadership