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Harlem Elderly Receive Integrated Mental Health Care
Harlem’s older population has not been getting the help for mental illness it needs and now a grant from the Fan Fox and Leslie R. Samuels Foundation is addressing this problem. The grant makes it possible for the Thelma C. Davidson Adair Medical/Dental Center to integrate mental health services into the center’s primary care setting. The Adair Center, located in the Mannie L. Wilson Towers in Harlem, provides medical and dental services to families, with a special emphasis on the elderly population in Northern Manhattan.
   “Mental illness in our patient population interfered with our ability to provide adequate primary care,” says Robert Lewy, M.D., senior associate dean for health affairs and medical director of the Center for Community Health Partnerships, the non-profit umbrella organization under which the 3-year-old Adair Center operates. “There is a stigma attached to obtaining mental health care in certain communities, and access to good care is difficult for low-income and elderly patients. That leads to an unusually high hospitalization rate for mental illness in Harlem – 80 percent higher there than in the rest of New York City.”
   Dr. Lewy and colleagues began working with the Fox/Samuels Foundation to design a program to channel psychiatrists’ services through primary care physicians. Starting this summer, a psychiatrist is reviewing certain cases to ensure patients receive appropriate care and will train the center’s primary care physicians to diagnose and treat mental illness.
   This collaborative care model is based on studies conducted and programs developed by Wayne Katon, M.D., professor of psychiatry at the University of Washington Medical School. Dr. Katon found that primary care patients diagnosed with and treated for depression by a mental health specialist in collaboration with the primary care physician showed improvements in their symptoms, complied better with their medical treatment and were more satisfied with their general care than those treated by the primary care physician alone.
   “This project offers an opportunity to evaluate whether a collaborative model of providing mental health services to primary care patients can work in the urban public sector,” says Mark Olfson, M.D., professor of clinical psychiatry and co-developer of the Adair Center’s mental health program. "If successful, this strategy may serve as a model for delivering mental health care to other urban patient populations."