Ask the Expert: Mental Health in Primary Care
We talked with James Ellsworth recently about mental health awareness within the context of primary care and what is known as the recovery model. While Ellsworth is an accountant by trade, he is also executive director of the Capitol Health Network, or CHN. It is composed of 14 health clinics and health-oriented community-based nonprofits that provide primary medical and behavioral health care and health-related services to underserved people in the five county region surrounding Sacramento.
More importantly, Jim himself is a person with lived experience. He has depression and Post-traumatic Stress Disorder (PTSD), but successfully manages both conditions while leading a regional organization.
Q: What is the challenge with mental health awareness within the primary care setting?
A: It’s often a poorly understood set of illnesses and many primary care physicians are not particularly focused on diagnosing them. The concept of mental health conditions being recoverable conditions really rubs against a lot of medical training. Many physicians tend to think of mental health conditions as permanent behavioral illnesses that are not recoverable.
Q: What is the recovery model?
A: It is a perception of mental health issues that proposes recovery, that emphasizes and supports a person’s potential for recovery. The recovery model is often described as a personal journey. It’s hope, not just optimism. Hope coupled with an understanding of a condition can afford you security and a deep sense that everything will be OK. We know the recovery model works because of the scientifically based studies of it that demonstrate improved health outcomes.
Q: What has been your own experience with the recovery model?
A: When I feel a depressive episode is coming on, I know people around me understand, and I’m not afraid to share that. My co-workers and family recognize this condition and, more importantly, know how to help me. As a result, my depressive episodes will be shorter. Knowing what depression is, knowing what it looks like and feels like, all of this gives me a sense of security, and security is one of the foundations of recovery.
I’m grateful for the opportunity to stand out in my community and say “yes that’s me, too.”
Q: What is the potential of the recovery model to to find greater acceptance in both the general and primary care community?
A: The potential is tremendous, especially when you consider the Affordable Care Act’s opening access to behavioral health services. Locally, Community Health Centers are actively integrating behavioral health services. I believe it is just a matter of time, hopefully not much time, that this “cross pollination” of medical and behavioral health providers expands knowledge of the recovery model’s effectiveness and it is more broadly adopted by the provider base, resulting in better mental healthcare outcomes for more people.