There need to be better coordination of care and treatment standards between medical and mental health providers, especially where it concerns those diagnosed with mental illness.
There has been a systemic problem within the mental health care system in Arizona for a long time now concerning the lack of proper medical testing and follow up of SMI patients diagnosed with certain mental illnesses, like Anxiety Disorder Bi Polar Disorder and Post Traumatic Stress Disorder or PTSD.
This is because for years now the state of Arizona has otherwise insisted on differentiating between mental and medical health care services – in a misguided effort to save money and cut costs.
To the point where you have a situation today where we could have hundreds, if not thousands of patients, who qualified for mental health services, through Magellan, in terms of having a qualifying diagnosis for “Serious Mental Illness” (SMI), at the same time they were actively denied or refused AHCCCS medical coverage.
AHCCCS stands for “Arizona Health Care Cost Containment System.”
For too long now SMI patients have been denied AHCCCS medical insurance for all kinds of arbitrary and unfair reasons, including being a single adult, without children or dependents living in the home? Despite the fact that in many cases these individuals are desperately poor and meet the income requirement to qualify for AHCCCS.
This “exclusion policy” has served as an insurmountable barrier to many SMI patients in Arizona who fell under that particular category from getting the proper medical testing and care they needed to distinguish between a medical or mental problem or illness to begin with.
In almost all of these cases, proper medical testing and follow up was not preformed on those individuals with SMI qualifying diagnosis’s, including such things as:
1) Anxiety Disorder
2) Bi polar disorder
3) and PTSD or Post Traumatic Stress Disorder.
In the case of “Anxiety Disorder”, for example, doctors need to be aware that many medical problems, including hormonal and neurological illness can also cause symptoms of anxiety.
For “Bi-polar disorder – doctors should rule out other causes of the illness, before issuing out a diagnosis, such as “hyperthyroidism” which requires medical testing to determine.
For PTSD – doctors should preform a complete physical including a brain imaging scan to determine if this is a mental or medical disorder. Including seeing is the area involved in emotional processing such as the hippocampus is “reduced” in size or not. In addition doctors should determine if the amygdala is overactive and/or the pre-frontal cortex is under-active.
As far as I can determine none of these kind of medical testing and follow up is going on right now.
It is my hope that with the big push for “integration” of health care coming – we might finally be in a position where we can effectively deal with this issue – instead of just ignoring it.