Healing Body and Mind: A Critical Issue for Health Care Reform

It doesn't make sense to treat Dan's bleeding ulcer, without attention to the depression that spurs him to drink alcohol excessively, which contributes to ulcer development. Nor is it prudent to ignore Nancy's anxiety that prevents her following through on chemotherapy for breast cancer. The connections are obvious, yet today connecting treatments for mind and body is a rare occurrence. Mental health and substance-abuse disorder assessments and interventions are separated by the payment mechanics of health plans, which encourage independent delivery of services. Dr. Kathol, a veteran internist and psychiatrist, shows the physical, emotional, social, economic and legal effects of what he calls headless health care. He illustrates with patient stories the profound impact that emotional issues and/or psychiatric disorders have on physical health and, conversely, the impact medical illness has on mental health.

This book begins with stories of real patients suffering with concurrent behavioral and physical disorders who are forced to navigate a health care system that fosters what Kathol calls inferior care, escalating the costs and perpetuating personal impairment. He calls for health system reorganization wherein behavioral health becomes an integral part of physical health—integrated health care.