Letter to Editor, SF Chronicle January 11, 2011

Jared Lee Loughner appears to have been paranoid, delusional and probably suffering from serious mental illness.

His community college had forced him to leave and told him to get a mental health assessment.

We need to reshape the way behavioral health is provided in the U.S. Siloed medical health and behavioral health (the latter being mental health and substance use) result in separated and fragmented administrative and service delivery structures. The current fiscal climate can be a stimulus to integrate behavioral health into primary care so patients have both their physical and behavioral needs met.

What is the most efficient, effective way to treat both? Integrated care, whether behavioral into primary care, or primary care into specialty mental health facilities, or both, is the best way to meet the full spectrum of patients’ needs. Integrated care is the way to end the terribly destructive mind-body schism that has gone on for too long in this country.

Florence Fee, San Francisco

Integrated care is associated with greater depression care satisfaction

(Unutzer et al, JAMA 288: 2836-2845, 2002)