Social Workers On Staff: A New Approach To Primary Care




John is suffering from both physical and mental health issues, so he goes to his primary care provider’s office to seek treatment for the physical problems. After his evaluation, John is surprised when his doctor introduces him to a social worker who works in the same office and helps patients with mental health challenges.

There is a long-standing problem in health care. Although mental health and substance abuse issues are often linked with physical health problems, they are usually treated separately from medical care and as a result, many mental health issues go untreated. That is why an increasing number of primary care providers are bringing social workers into the office — to prevent patients from falling into the space between physical and mental health treatment. It is often an adjustment for patients to see a social worker in this context, but it can be greatly beneficial to be able to address all health issues in one office.

According to the Blue Cross Blue Shield Foundation, “nonmedical factors play a substantially larger role than do medical factors in health.” They found that social, behavioral and environmental factors determine a whopping 60 percent of one’s overall health. Yet, while it is considered perfectly normal to visit your primary care provider for medical reasons (like illness or doing a routine checkup), many still consider it unusual or unnecessary to go to a mental health care provider.

Mental health issues have also been shown to increase a person’s chances of getting sick and to exacerbate existing physical illnesses. For example, depression has been linked to stroke, coronary heart disease, multiple sclerosis, colorectal cancer and other physical conditions. Mental health challenges also make a person more likely to make poor health choices, including abusing alcohol or drugs, eating poorly and exhibiting reckless behavior.

Even though social workers are better suited to treating mental health issues, such as depression or substance abuse, 74 percent of patients who seek help for these challenges go to a primary care physician. However, primary care clinics miss diagnoses, including not recognizing depression up to 50 percent of the time.

When a primary care provider detects symptoms of a mental health issue, she traditionally refers the patient to a social worker or a specialist. While patients often agree to contact the reference, less than 25 percent of them do, which means they fall through the space between primary care providers and mental health professionals. Without making that connection, the mental health issue persists, affecting their lives and potentially worsening the physical condition for which they were originally seeking treatment.

For example, John is suffering from ulcers, so he goes to see his primary care provider to receive treatment. During his evaluation, John’s doctor feels John might have acute anxiety issues and refers him to a therapist. John takes the number and promises to call, but later decides he would be embarrassed getting out of his car in front of a therapist’s office. He never makes the call, his anxiety persists, and he has to go back to the doctor a couple of months later with new ulcers.

Situations like this are so common that more and more primary care providers are deciding to employ social workers in the same office. If John’s doctor had a social worker in house, instead of making another appointment, overcoming the stigma of mental health treatment, and creating a new relationship with a different medical professional, John could simply walk down the hall to the social worker’s office. Now, John is dealing with his issue immediately and is much more enthusiastic about pursuing follow-up treatment.

Although it can be strange for patients to see a social worker in their primary care provider’s office, it is ultimately worth the adjustment, if it means seeing someone immediately. Treating mental health challenges is critical to a high overall quality of life, and social workers in a primary care provider’s office are literally in the perfect place to get patients the treatment they need.