Each May, the medical community pauses to give extra attention to the very real subject of mental illness. According to the National Institute of Mental Health, more than 40 million Americans suffer from anxiety related disorders, while 20 million are afflicted with mood disorders like major depressive disorder and bipolar disease. Another 2 million adults have schizophrenia. Add it up, and that’s more than 26 percent of Americans suffering from mental disorders any given year.As experts work to unlock the mysteries of the mind and do a better job of integrating mental and physical health, Nashville’s Mental Health Cooperative is bringing hope to adults and children with persistent mental illness and serious emotional disorders. Founded in 1993, the behavioral health agency provides outpatient illness management, rehab and recovery with a focus on the underserved. In 2013 more than 22,000 clients (including 6,600 children) were served through their nine middle Tennessee facilities. Healing Body & MindLast year, the Mental Health Cooperative (MHC) expanded to include an integrated health clinic to offer primary care services for patients. More than 400 have received primary and well woman check-ups since the program kicked off in July. MHC also provides wellness education including smoking cessation classes, which have helped several patients kick the habit.“We know a lot of people with serious and persistent mental illness die 25 years earlier than the general public, often due to lack of access to primary care or because they don’t actively seek it out,” said Amanda Bracht, LCSW, chief clinical officer for MHC.

Lifestyle choices and medication (with its sometimes negative side effects) also contribute to shortened life expectancy, especially among those who fall below the poverty line. For many mentally ill patients, a lack of primary care means frequent visits to the emergency room, driving up hospitals costs and landing patients in an environment with limited resources for mental health needs.“One thing we noticed right away is that so many are getting physicals for the first time in years,” Bracht said. “Many can’t tell us when they last saw a primary care doctor, and we’ve had 40-year-old women who’ve never a had a well woman exam. We’re focused on increasing overall wellness and healthy lifestyles.”Providing primary care to mental health patients has a unique set of challenges, which MHC’s staff is accustomed to meeting. Appointments require substantially more office time compared to a traditional primary care clinic, often due to patients’ distrust of medical providers. And while patients might otherwise ignore primary care appointments, MHC’s hands-on case management personnel help schedule appointments and ensure patients follow through. MHC & Pediatric PatientsMHC also is integrating primary care and mental health for pediatric patients, who often suffer from severe forms of ADHD. A new initiative locates clinicians inside pediatric offices, allowing patients to receive comprehensive medical care in one location. The program currently is underway at Springfield Pediatrics and Lebanon’s Cumberland Pediatrics, with three more area partnerships in the works.“It’s been a great arrangement, and we’ve had immediate success with patients getting connected to a child psychologist who can consult with the pediatrician to determine the best course of treatment,” Bracht said. “There’s also an element of comfort for the pediatrician knowing they’re doing the right thing for the patient.”Overcoming Stigmas Bracht, who has been with MHC since 1997, has seen positive steps taken in overcoming the social stigma once attached to mental illness.“More people now understand that mental illness is a disease that affects the brain and isn’t due to bad parenting or lifestyle choices per se,” noted Bracht, who also provides mental health training to the community and law enforcement. “In my time here, there have been wonderful changes. People are more willing to access resources than ever or admit when they or someone in their family has dealt with mental illness.”Hope Through Early DiagnosisWithin the greater healthcare community, an ongoing obstacle is getting providers to recognize signs and symptoms of mental illness early on, before crises occur. The sooner diseases like schizophrenia are diagnosed and treated, the better the patient’s long-term prognosis.Bracht encouraged practitioners to educate themselves on mental health resources available in their community and to develop partnerships and an ongoing dialogue with groups like MHC. Their 488 staff members include a large number of bachelor’s or master’s level case managers, and master’s level therapists and crisis counselors. MHC also boasts six full time psychiatrists, 14 nurse practitioners and a peer specialist whose own experience with mental illness supports and encourages patients.“Mental illness can be very scary, but we’re able to educate clients about proper treatment and let them know that there is life after diagnosis, and that our younger clients can go on to college and have a career,” Bracht said. “They just need the right support and to know it’s okay to seek out mental health treatment. The earlier they get it, the better outcomes will be.”