We at SSTAR are proud to have blazed a trail providing integrated behavioral health and primary health care over the past 30 years which may serve as a model for others trying to meet new Federal standards. Provisions outlined in President Obama’s Affordable Health Care Act draw attention to things we have already learned—that people who suffer from mental health or addiction issues are more likely to suffer physical ailments and illnesses, and die at a younger age than the general population. The Affordable Health Care Act also recognizes that people treated for these issues, have a better shot at staying healthy if they are provided with specific options for primary care.
Though this is a new paradigm for the Federal Government, we have had our feet planted firmly in both fields for years. Of course our journey—like all great journeys—began with baby steps. SSTAR began in the late 1970s as “the Center for Alcohol Problems—a fledgling alcohol detoxification and treatment program. Our facility subsequently went through various incarnations—adding a mental health clinic and services for women who had experienced trauma.
We truly began our foray into providing integrative services in the mid 1990’s, as a response to the HIV/AIDS crisis. We ramped up our efforts to provide primary care, launching our first Family Health Care Center. This was begun with a limited internal medical practice and has grown to what it is today: a comprehensive clinic staffed with general practitioners and specialized physicians and nurse practitioners offering services ranging from nutrition counseling to case management which treats over 5000 patients per year. Other programs on site that were created over years to serve the multi faceted needs of our clients include the state’s first HIV walk in testing clinic, our Intensive Outpatient Program and our Ambulatory Behavioral Health Facility.
Our doctors, counselors and case managers knew how important it is to treat the whole person, long before words like holistic became part of our collective dialogue. We recognize that all health conditions are intertwined. For example, someone with depression might not be eating well and may be guided to exercise. Someone with substance use issues may have shared needles or had unprotected sex and may be interested in getting an HIV/AIDS test. A person diagnosed with a chronic illness may benefit from counseling. As the norm in health care across the country has been compartmentalizing problems and specialties, it is easy to lose site of the whole person. Yet, it shouldn’t be.
For years, we have offered an approach to care which we have dubbed “one stop shopping” which allows patients to learn about various options they have for their health—many of which they may not have previously considered. Elise Kennedy for example was using drugs for 23 years, and had been in and out of various programs before she detoxed and started using SSTAR’s intensive outpatient program. She subsequently utilized counseling services; but also connected with our primary care physicians to help her manage her Hepatitis C; and our nutritionist to teach her to eat right again, to lose weight and to stop smoking.
“The best part about SSTAR is that they offer you peace of mind. There are so many options, and they provide you with all the information and offer suggestions. You aren’t a number, you are a person. Once you are with SSTAR, there you are. They don’t ship you off anywhere. You can get everything you need on site. You never have to worry that your needs wont be met, no matter what they are,” Kennedy said.
In addition to giving our clients peace of mind; this way of working enables our physicians to treat patients with a wide range of problems. In the community when physicians encounter patients dealing with substance use issues, they generally find it difficult to develop a plan of action because they have not been trained what to do. Our physicians treat clients with substance use or other behavioral health issues on a daily basis. Thus, they learn a wide range of skills, and are able to treat a wide range of patients.
Of course, we know there is always room for expansion and improvement. We recognize that just as society is in a constant state of flux, people’s needs change, and health care should never be static. Accordingly, we are constantly seeking to improve ourselves. We draw on the lessons we have learned about integrative care, to take things to the next level. Accordingly, last spring we opened a cutting edge Methadone clinic integrating primary medical care, behavioral health, HIV testing and counseling, Hepatitis C testing, case management for chronic illness, methadone treatment and substance use counseling for clients in our City’s South End. This is the first integrated primary, behavioral and methadone clinic in Massachusetts.
We recently received a grant from SAMSHA to improve the physical health of patients with serious mental illness who have or are at risk for co-occurring primary conditions and chronic diseases. This grant called the HIP will allow us to integrate the physical and behavioral health care of clients on a larger scale. It will also allow people with substance use disorders to access primary care doctors, who can keep abreast on a spectrum of issues regarding clients’ health. This grant will help us continue to learn how integrative behavioral and primary health services relate to each other, and to develop best practices to serve the community.
SSTAR has always recognized the value of learning by doing. With each new program we are fortunate enough to be able to include in our facility; we are able to gauge what works and what doesn’t. These practices are influenced by both our clients’ and staff needs and feedback.
When in doubt, we fall back on lessons learned throughout our history. The ground at our facility was primed a long time ago to integrate clients’ physical and behavioral health needs. As always, we are proud to be one step ahead of the curve.