It's "full speed ahead" for the Affordable Care Act and health-care providers are figuring out how to implement the law's many changes.

 

The federal law calls for better integrating mental and physical health care, for example, to offer both services in one location. This approach is typically offered in primary care offices, but a Philadelphia clinic dedicated to women's health needs is also using the integrated care model.

The Helen O. Dickens Center for Women's Health, a Penn Medicine clinic in West Philadelphia, began using this integrated approach earlier this year. Staff members say the OB-GYN setting makes perfect sense as a place to tie in mental-health care.

OB-GYN doctors typically ask their patients about mood, stress, and general well-being. But that doesn't mean they can offer a solution if there's a problem, says psychiatrist Neill Epperson who directs the Penn Center for Women's Behavioral Wellness.

A patient might have symptoms of depression or anxiety, but be unable to get an appointment with a mental health professional for several weeks.

The Dickens Center addresses this issue by offering not just screening but counseling services in the same location, Epperson said.

She offers the example of women seeking OB-GYN care during pregnancy.

"Our thought was, if we could combine mental-health visits with prenatal visits, patients might be more likely to seek out mental-health services and be able to follow up on a regular basis because they are already coming regularly," Epperson said.

Consolidating visits to ease jitters

The Dickens Center staff is often able to schedule the appointments back-to-back, says psychiatrist Delane Casiano, who directs the the maternal wellness initiative at the center. In addition to making mental-health care accessible, Casiano hopes women of all ages will feel more comfortable since mental health is just part of their visit.

She says it makes her less "mysterious." Instead of "the psychiatrist," she is one of the doctors, says Casiano, and patients have a face to go with her name.

The Dickens Center has been a helpful resource for Deborah Phillips. She had been seeking mental-health care for months for a worsening depression, but couldn't get an appointment with any of the providers she called. While at a visit preparing for an OB-GYN related surgery, she connected with Casiano.

"It was good for me," said Phillips. "It was just what I needed, because I needed somebody to talk to, somebody to hear me out."

Phillips says her regular visits with Casiano have made a huge difference in her life.

Casiano hopes that the Dickens center will serve as a national model for making mental-health care part of regular checkups.