2 posts tagged “physical health”

Primary care that treats mind and body? It’s happening in Alaska

Posted January 25th, 2018 by

Integrated care for both mind and body under one roof? It may sound pie in the sky, but it’s really happening at an award-winning healthcare center in Anchorage, recently featured in Politico. How does it work? And can it be replicated?

A shining example in Anchorage

“It’s a truism that the mind and body are connected, but the U.S. health care system has long treated them as separate — with separate doctors, separate hospitals, separate payment systems,” Politico reports (detailing the history of these health care “silos”).

The Southcentral Foundation, which runs a healthcare center for native Alaskans in Anchorage, is in the spotlight for successfully bridging the mind/body divide.

“In part because of their Alaska Native heritage, which puts a high value on spiritual health, the leaders of Southcentral recognized decades ago that behavioral health is tightly linked with bodily health,” Politico says. “So they became one of the early adopters of integrated care.”

At Southcentral, checkups include a mental health evaluation, and a patient’s primary care team includes on-site psychologists or social workers.

For one patient, Vera, profiled in the Politico piece, “accessing mental health treatment was as easy as going to her regular doctor, and there was no stigma attached: Her mental health services were provided at the same time and in the same place as other medical care, just like heading down the hall for an X-ray or a blood test.” Vera was sexually abused as a child and later diagnosed with major depression. She experienced suicidal thoughts and may not be alive today without the integrated care she received at Southcentral, she says.

Advantages of integrated care

The World Health Organization (WHO) has recommended integrating mental health care into primary care for decades. Here are some of the benefits of integrated mental/physical health care that WHO outlined back in 2001:

  • Less stigmatization of patients and staff, as mental and behavioral disorders are being seen and managed alongside physical health problems
  • Improved screening and treatment, in particular improved detection rates for patients presenting with vague somatic (physical/bodily) complaints which are related to mental and behavioral disorders
  • The potential for improved treatment of the physical problems of those suffering from mental illness, and vice versa
  • Better treatment of mental aspects associated with “physical” problems

A popular notion — and the roadblocks

Research has shown that Americans value physical health and mental health equally. Also, “nearly half of Americans think they have or have ever had a mental health condition (47 percent), yet fewer than two in five have received treatment (38 percent),” according to a 2015 survey by the Anxiety and Depression Association of America.

In a 2017 PatientsLikeMe poll of more than 2,000 members, support for the Affordable Care Act (or “Obamacare”) is highly popular among those living with mental health conditions, perhaps because the policy’s “parity” requirement means that insurers have to cover mental and physical health issues equally.

Politico reports that there’s broad support for physical/mental (behavioral) health integration in both the healthcare sector and in Congress.

The Southcentral Foundation won the Malcolm Baldridge National Quality Award in both 2011 and 2017 for its innovative, top-quality care (psst: 97% patient satisfaction) at a relatively low cost. Douglas Eby, vice president of medical services at Southcentral, says he is often invited to speak at conferences in Washington, D.C., because the Southcentral model is “popular with the whole political spectrum.” (What? Whoa.)

So what are the biggest hangups? Money and stigma.

The U.S. health care and insurance system is structured in such a way that doctors are paid more for (physical) procedures, and they can actually lose money by integrating mental health. The longtime stigma of mental illness extends into the provider space, where mental health clinicians and services are valued much less, dollar-for-dollar, than their “physical care” counterparts.

“Solving these problems will take more than money; it will require changing the culture of medicine,” Politico concludes.

On PatientsLikeMe, thousands of members are living with both physical and mental-health conditions. Join the community today to talk about topics like this with patients like you!

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Living with depression? Grab your mat: 5-minute yoga video with Jamie from PatientsLikeMe

Posted June 7th, 2017 by

Studies have shown that practicing yoga can have positive effects on people with depression. So we tapped Jamie – a PatientsLikeMe research assistant who is also a certified yoga instructor – to show us some poses with mental health in mind. She put together a 5-minute, beginner-level flow that you can try at home. (As always, check with your doctor before trying a new type of exercise.)

Yoga for depression

“I practice yoga to manage my mental and physical health, and to bring mindfulness to my day,” Jamie says. Don’t speak yogi? Here’s a breakdown of the poses (and phrases) featured in the video, plus some of their perks:

  • Pranayama – The practice of purposefully controlling or regulating your breath. Benefits: Settles the mind and body in preparation to practice yoga.
  • Dirga (pronounced “deerga”) – A form of pranayama, this three-part breath involves inhaling into your lower belly (with your right hand on your belly), then into your diaphragm or midsection of the lungs, and finally into the chest (with your left hand on your chest) – and reversing this flow when you exhale. Benefits: Helps increase oxygen to the heart and lung to counteract shallow breathing – which can occur with depression or anxiety, frequent sitting and poor posture.
  • Cat/cow – A pair of simple poses done on your hands and knees. For “cow,” inhale as your belly drops and your gaze rises, and for “cat,” exhale as your spine rounds and your chin comes to your chest. Benefits: This flow brings awareness and energy to the entire length of the body while also creating flexibility in the spine.
  • Downward dog, or “downdog” – Another simple pose, done on your hands and feet, that involves the entire body and lengthens the back from head to foot as you bend at the waist. Benefits: It’s gently energizing and balancing for the mind and body.

Yoga for depression

  • Sun salutation A, or “sun A” – One of the easiest and most common sequences in yoga, which can be done at any pace to be more or less energizing. It involves reaching upward toward the sky, then folding forward to touch your shins or the floor, stepping back into a plank pose, lowering your body to the floor, then pressing up with your arms and chest into a “cobra” pose, and finally, returning to a tabletop (hands and knees) and a “downdog” bend – repeating the sequence as needed. Benefits: Gets blood flowing and builds energy during your yoga practice.
  • Locust – Laying face-down and raising your chest, arms, lower legs and feet off the floor. Variations include keeping your arms at your sides and hands reaching straight back (think: “Superman” style) or interlacing your hands behind your lower back for even more of a stretch. Benefits: Helps open the chest to combat poor posture or slumped shoulders, which can come from feeling withdrawn or physically closed off – common symptoms of depression.

Yoga for depression

  • Plow – A back stretch that involves laying on your back and reaching your legs and feet overhead, touching your toes to the floor above your head. Benefits: It quiets the nervous system, relieves irritability and serves as a full body renewal.
  • Supine bound angle pose – A hip-opening pose where you lay on your back with your feet together and knees apart (think: “butterfly” style). Keeping your hands on your chest and belly helps you focus on breathing and relaxation. Benefits: This restorative pose can relax the mind and body.

The latest yoga/depression research

More than 15 million Americans practice yoga, and there’s increasing evidence of yoga’s physical and psychological benefits.

New research published in Psychological Medicine is the largest study of the yoga/depression connection to date. The study involved 122 adults with moderate depression. Half of them were randomly assigned to try hatha yoga (most forms of yoga practiced in the West), while continuing treatment with anti-depressant medication. After 10 weeks, the yoga group didn’t show significant improvement over the “control” group, but after six months, 51 percent of those who took yoga (about three sessions per week) experienced a 50 percent reduction in symptoms (compared with a 31 percent decrease in symptoms in the non-yoga group).

The takeaway? Yoga may not alleviate depression symptoms right away, but the benefits may build when yoga is practiced regularly over a longer term.

On PatientsLikeMe

Hundreds of patients report using more than a dozen different forms of yoga as part of their treatment plan. See how patients with major depressive disorder are using yoga and how they rate its effectiveness.

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