The American health care system is broken. Unfortunately, that’s no surprise to anyone who has tried to piece together a disconnected network of health professionals — many of whom practice independently, have little if any connection to one another and who find it difficult, if not impossible, to effectively share a patient’s medical information. This reliance on disconnected clinical practices often produces fragmented patient care, confused patients and unnecessarily sub-optimal outcomes. 

This disconnect is acutely evident in the area of substance use disorder treatment and mental health. Thankfully, we are finally breaking down many of the barriers to an integrated care delivery model — what has been called the “gold standard for addressing co-occurring mental health and substance use disorders” by the National Institute on Drug Abuse. 

Here at Integrity House, we have long been implementing an integrated care model that coordinates physical, mental and substance use disorder care under a single roof. And the proof that it is working is in the better patient outcomes and improved health results we are seeing in many of our clients. 

People hear about Integrity House and they immediately think of substance use treatment and recovery — which is no surprise, since this is the platform that the organization was founded on 55 years ago. But with the increasing prevalence of co-morbidities, exacerbating and complicating treatment and recovery, it was essential to take a wider view of treatment and recovery services, resulting in us providing a full and comprehensive continuum of care through our integrated care program. 

Integrated care is all about treating not just one aspect of an individual, but treating the whole person, and being able to do that under one roof. Through our federally funded Certified Community Behavioral Health Clinic, we have been able to integrate substance use treatment, disease specialists, mental health specialists, primary care specialists and care management all in one primary location. This approach offers greater connectivity and communication between the specialists servicing the client and is far more convenient for our clients, increasing their adherence to medical instructions and prescriptions. Most importantly, it is yielding better and more consistent outcomes. 

New Jersey currently has 12 CCBHC locations in seven counties — Atlantic, Bergen, Burlington, Essex, Mercer, Middlesex and Monmouth. The CCBHC model enables a client to walk in without an appointment, where they are almost immediately seen by a medical professional who performs a comprehensive assessment. A client may, for example, present with headaches or fatigue. Rather than simply prescribing a short-term symptomatic “fix,” the initial assessment, in this example, might enable the clinician to ascertain that the patient is experiencing hypertension, sometimes attributed to misusing alcohol. They can then be seen by a clinician who can screen for alcohol use disorder, determine where they fall within the spectrum, and have a more in-depth conversation with the client where we are able to say, “You may be drinking a lot because you are experiencing symptoms of depression, or as a result of trauma that you may have incurred.” In this example, we can link them with psychiatrists who can then treat the symptoms with medically indicated medications or engage the client in psychotherapy. 

This integrated care model is especially beneficial to those who may need longer-term care. As  behavioral health providers, we often see clients who have chronic conditions which have developed over 10, 20 or 30 years of the damaging effects of substance use disorder. We now know that the most effective path to sustained recovery and long-term health is through integrated care that treats the whole person — not just their addiction, but also their mental health and physical ailments.  

The CCBHC model works. It now has a proven track record of success: New Jersey’s CCBHCs have dramatically improved access to community-based substance use treatment and mental health care and expanded access to medication-assisted treatment and other services, all while considerably reducing patient wait times. Yet, significant barriers — such as financial cost and administrative obstacles — continue to obstruct the expansion of the integrated care delivery that CCBHCs provide. But the success of this model is incontrovertible. I urge the federal and state health care authorities to provide the funding necessary to sustain and expand integrated care through CCBHCs to every county in New Jersey.