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MENTAL HEALTH Local doctors' offices shift to treat the whole patient By Vickie Aldous Mail Tribune Follow @@VickieAldous MailTribune.com By Vickie Aldous Mail Tribune Follow @@VickieAldous Posted Aug. 23, 2016 @ 2:00 am Updated Aug 23, 2016 at 12:09 PM By Vickie Aldous Mail Tribune Follow @@VickieAldous Posted Aug. 23, 2016 @ 2:00 am Updated Aug 23, 2016 at 12:09 PM » Social News p bs:newslist StartDate="20121121" EndDate="p bs:datecalc Months="3"" DateSort="1" UseObjects="1" ObjectClass="81" Taxonomywords="2325,665" ExactTaxonomyMatch="1" Image="1" Count="4" --> Dr. Mary Murdoch knows the issues patients bring up as afterthoughts can sometimes be critical. "Often, the 'Oh, by the way' comments are the biggest thing," she said. Not used to discussing mental health issues with their primary care doctors, patients often mention as asides they are struggling with depression, stress, anxiety, addiction and other problems. As a doctor, Murdoch is trained to address those concerns, but since March, she's also had a psychologist working alongside her and other pediatricians at Southern Oregon Pediatrics in Medford. She can refer patients directly to Dr. Jared Cox, the pediatric clinic's on-site behavioral health consultant. "We love it now because we can provide good, quality care for those important issues," Murdoch said. Cox sees patients in the pediatric clinic's exam rooms, or he can talk with a patient in a separate room with a comfortable, cozy couch and chairs. Research shows when primary care doctors advise patients to seek mental health care at an outside location, patients follow through only 10 percent of the time, Cox said. But put a mental health worker right there in the doctors' office, and patients will visit that specialist 80 percent of the time, he said. The merging of physical and mental health care at Southern Oregon Pediatrics is part of a nationwide trend to treat the whole patient. Rogue Valley efforts received a boost when Jackson Care Connect, a coordinated care organization, announced this summer it is investing $487,500 over the next year to help medical clinics add mental health workers. The money will also help support clinics that already offer mental health services. "The idea is to treat behavioral issues just like any other health problem a patient might bring to the doctor's office," said Laura Heesacker, a social worker and behavioral health specialist with Jackson Care Connect. "We hope to take away the stigma associated with seeking care and help patients get the help they need immediately, instead of waiting or having needs go untreated." Cox said patients can have a broad range of mental and behavioral health problems. People who suffer chronic pain experience depression 50 percent of the time, he said. A patient with diabetes may need to make behavioral changes, but may not know how to do that, Cox said. "The medical doctor may say, 'You need to eat more fruits and vegetables, exercise more and eat less fast food.' I may step in and help them hammer out goals and do planning," Cox said. "To get a sense of their concerns about their health condition, I might ask, 'What do you want to be different?' Based on how important the change is to the person, we can identify next steps. For example, what are some of the things they've done in the past that were helpful? If they haven't experienced success, what's one small change they could make?" Cox can help patients figure out ways to increase their physical activity, make diet changes, develop stress-management skills and improve their social connections. Pediatricians at Southern Oregon Pediatrics screen patients ages 12 and older for depression, substance use and other concerns. If they identify issues, they can tap Cox. "In the span of 15 minutes, I can do an assessment," he said. "I can ask, 'What's triggering the depression? What are you doing to cope?' " Treatment strategies can include arranging follow-up visits with Cox or visiting Jackson County Mental Health or a private mental health practice. With adolescents, Cox tries to talk to the patient individually, then the parent or caregiver, then the two together. "Adolescents may not want to share important information if the parent is in the room," he said. Ultimately, his goal is to have the parent aware of the plan to help the teen, especially since addressing behavioral health issues often requires family cooperation. Medical clinics that treat adults are also joining in the effort to merge physical and mental health care. Anxiety, depression, bipolar disorder and substance abuse are among the problems Katie De Vry sees as a behavioral health consultant at Asante Physician Partners Internal Medicine Clinic-Ashland. Like Cox, De Vry sees chronic pain patients who are also suffering from depression. "Especially with chronic pain, it impacts their mental health, well-being and quality of life," she said. De Vry can help patients who want to quit smoking or who have problems with alcohol, as well as those who are addicted to drugs. "With addiction, it's an issue of coming to terms with the addiction and understanding the road to recovery," she said. "I tell people, 'It won't be a walk in the park. It won't be easy. It's OK to have a hard day.' " De Vry helps people with addictions understand the range of treatment resources in the community, from outpatient counseling and drug-treatment services to inpatient medically supervised detox. Research shows when clinics integrate physical and mental health care at one location, health care provider and patient satisfaction both go up. Patient problems such as depression and anxiety improve, and health care costs can be reduced because there are fewer emergency room visits, Cox said. Murdoch said combining physical and mental health care makes patients feel more comfortable about seeking the care they need. "Some people are nervous about seeing a psychologist or psychiatrist," she said. "It's less intimidating and anxiety-provoking to see another part of the team in the pediatric office." Staff reporter Vickie Aldous can be reached at 541-776-4486 or [email protected] . Follow her at www.twitter.com/VickieAldous . By Vickie Aldous Mail Tribune Follow @@VickieAldous MailTribune.com By Vickie Aldous Mail Tribune Follow @@VickieAldous Posted Aug. 23, 2016 @ 2:00 am Updated Aug 23, 2016 at 12:09 PM » Comment or view comments Terms of Service /* $( document ).ready(function() { // Jquery mobile is trying to style the button and leaving a blank gry button on top of a white button $("#viafouracoms .vf-comment-controls li.vf-right").html(' Submit '); });*/ » STAY INFORMED Email NewsLetter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. calendar Connect with MailTribune.com Facebook Twitter RSS Back to top Reader Services Reader Services Home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Announcements Obituaries Story ideas Since you asked Alerts Email Alerts RSS Feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Propel Marketing Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Mobile Site Stay Informed Email newsletter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. 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