VOL. 2 | Summer 2010

C O m m u n i t y H e a Lt H i m p a C t S e r i e S

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a b o u t t h i s s e r i e s

The Community Health Impact Series is a series of special reports dedicated to highlighting one maineHealth program and how it’s making a true impact in the communities we serve. each installment will feature stories from patients who’ve experienced a significant improvement in health and quality of life as the result of a program delivered by maineHealth or a member of maineHealth.

About MaineHealthmaineHealth is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so our communities are the healthiest in america.

A SnApShot of mentAl heAlth in AmericA

• One in four people seeking primary healthcare services has a significant mental health condition. 1

• 54 percent of people with diagnosed psychiatric conditions are treated in primary care only. 2

• Psychiatric conditions are the leading cause of disability in the U.S. and Canada for ages 15-44. 3

• The most prevalent lifetime mental health disorders:

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Anxiety disorders 29 percent

Impulse-control disorders 25 percent

Mood disorders 21 percent

Substance use disorders 15 percent 4

1. Kessler r, Berglund p, Demler O, Jin r, merikangas Kr, Walters ee. Lifetime prevalence and age-of-Onset Distributions of DSm-iV Disorders in the national Comorbidity Survey replication. arch Gen psychiatry. 2005; 62:593-602. 2. Druss BG, marcus SC, Olfson m, pincus Ha. The most expensive medical Conditions in america. Health affairs. 2002 Jul-aug; 21(4):105-11.

3. http://www.nimh.nih.gov/health/topics/statistics/index.shtml

4. Kroenke K, et al. anxiety Disorders in primary Care: prevalence, impairment, Comorbidity and Detection. ann intern med. 2007; 146:317-325.

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With those insightful words from her primary care provider, Lucy began to describe her stresses at work and home, including spinal surgery and the sudden loss of her best friend. it all left Lucy, 52, feeling anxious and depressed. “i was the queen of stress,” she explains. Lucy began seeing anne Barker, a family nurse practitioner, as her primary care provider six years ago. So when the Boothbay Harbor resident visited anne for routine care in early 2009, anne knew immediately that Lucy was not herself and that she appeared overwhelmed and anxious. Lucy took an assessment for depression (pHQ-9) and another assessment for anxiety (GaD-7); the results of the assessments prompted anne to change Lucy’s antidepressant medications. Lucy, who jokes that she “flunked” her assessments, says, “i wasn’t suicidal or anything, but i was flat.”

anne immediately introduced Lucy to Stephanie Field, a social worker in the practice. Lucy started talk therapy with Stephanie, focusing on Lucy’s stresses and symptoms, emphasizing ways for Lucy to manage her reaction to stress. Lucy describes the positive changes to her health, saying, “it’s

been a life-altering experience. my life up until that point felt like it had been in black and white, and now i could see in color.” Depression and anxiety had taken a toll on Lucy’s life. “By the time i got home at the end of the day, all i wanted to do was ‘veg’ out or go to bed. i used to be the energizer bunny, and the last three or four years i’ve been a zombie—functioning but not really living.”

The combination of medication and therapy has been effective, and Lucy’s health has improved. “it’s been obvious to my family that i feel better,” explains Lucy, adding, “and i notice the difference. i’m becoming animated again.”

Lucy says she’s feeling comfortable in her own skin since she started seeing Stephanie and is no longer in constant internal crisis. “i don’t think people realize how exhausting anxiety is—physically as well as emotionally—when you’re constantly worried about everything under the sun.” Since she started working with Stephanie, Lucy feels she has her life back and is doing things that she gave up during bouts of anxiety and depression.

“I actually got into my garden for the first time in two years, because I haven’t really cared [before now]. It’s been so overwhelming.”

all Lucy’s care has taken place at the John andrews Family Care Center in Boothbay Harbor, where a team of providers, including mental health specialists, care forpatients in the same outpatient setting, an approach that improves access and coordination in a familiar environment.

Lucy credits her long-term relationship with anne for getting her the help she needed. “Having a relationship with the care provider, so when you walk through the door they know something isn’t right, that’s like when the doctor used to make house calls,” explains Lucy, adding, “Life is hard, and you can’t always go to your friends and family. a therapist gives educated guidance.”

“Something isn’t right, Lucy.”

Lucy is feeling comfortable in her own skin since she startedseeing a social worker and is no longer in constant internal crisis. “I don’t think people realize how exhausting anxiety is.”

207-775-7001www.maineHealth.org

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465 Congress St., Suite 600portland, me 04101

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The MaineHealth Mental Health Integration ProgramThe Mental Health Integration Program helps people get effective and efficient care for mental and behavioral health problems through primary care providers. Started five years ago, the program provides training and materials to primary care offices throughout the maineHealth system. Services include screening, assessment and treatment approaches for mental health conditions commonly seen and treated in primary care, including depression, anxiety and substance abuse.