David J. Woodlock President & CEO Institute for Community Living
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1 David J. Woodlock President & CEO Institute for Community Living Emotional Dimensions of Healthcare: A Prescription for Better Health February 28, 2018
2 The US spends more on healthcare and we are more technologically advanced than most every other country in the world. The average citizen has access to more health information on the internet than ever before.
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4 Despite innumerable efforts over many years, health disparities in many communities persist unabated. The rates and persistence of chronic diseases are not only rising dramatically, they are getting the better of us. Behavior is a major factor in chronic disease progression
5 Our health system is recalibrating to address chronic disease Health reform with a focus on Quadruple Aim New characterization of Super-utilizers & Population Health
6 Our health system is recalibrating to address chronic disease The impact of social determinants of health is increasingly appreciated by payers and medical providers Research and data analytics are building the case for behavioral health to impact the full spectrum of health needs. For those with SMI, and importantly, for those with toxic stress and chronic medical conditions.
7 What is the Connection? Social determinants cause toxic stress Toxic stress is uncomfortable AND causes biologic changes Profound discomfort over time leads to behaviors that temporarily make us feel better while simultaneously making biologic changes that lead to chronic disease.
8 Toxic stress is pervasive Poverty health disparities College kids 1950 s psychiatric inpatient 70% of primary care visits are for psychological and/or social issues
9 Compensatory Behaviors Work in the Short Run Despite overwhelming evidence and their own personal knowledge, people continue to engage in behaviors that cause or contribute to their chronic diseases. Drinking Drugs Smoking Inadequate Sleep Excessive Caffeine Excessive Carbohydrate Consumption Sexually Risky Behavior
10 Medical providers are in a tough spot. Uncomfortable, under prepared under resourced.
11 Many innovative efforts to address this knowledge-behavior-chronic disease cycle have shown, at best, minimal effectiveness. This is NOT about more education. I may well know about the negative impact of my behavior but be unable to change. Why? The why is the why in people s behavior. The why is the compensatory nature of these behaviors, and the noble purposes they serve in managing the toxic stress related to ACEs, environmental and negative social conditions.
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13 How many of you have heard of Distress Tolerance? Cognitive Reframing? Motivational Interviewing? CBT?
14 BH is uniquely positioned to address the Emotional Dimensions of Healthcare the WHY
15 have
16 These concepts provide new opportunities for improved health for people with mental illness
17 New Frontier These are new and foreign concepts to most of the healthcare world They are coming guaranteed Talk with payers in your community Find like-minded medical practices Help to give words and a path forward to a daily struggle they are frustrated by. Patient s persistent/compensatory behaviors in the face of chronic disease. Offer to take on referrals for the patients with SMI they struggle with
18 New Frontier Engage with CCBHCs and/or FQHCs in your community Greater flexibility in payment models to be innovators in emotional dimensions of healthcare More skin in the game with outcome/performance payments
19 To learn more about Emotional Dimensions of Healthcare Contact us by: Phone: Visit our website:
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