OMH News
November 2010
Making Health a Priority for OMH Consumers
by Cassis Henry, MD , Columbia Public Psychiatry Fellow; and Lloyd I Sederer, MD , OMH Medical Director
Recent years have made it plain that as many OMH consumers age, their health problems grow and can often compromise the quality of their lives. To meet the health needs of our patients OMH has begun monitoring consumer health measures and is using this information to inform and support the wellness efforts of recipients.
Monitoring health: Since January 20, 2009, all OMH-operated adult clinic services are monitoring (four times a year) three critical indicators of physical health and medical risk: smoking status, Body Mass Index (BMI), and blood pressure (BP). Adults hospitalized in OMH-operated psychiatric centers are also routinely tested for cholesterol and other lipids (fats), fasting blood sugar (which helps to diagnose diabetes or a state which could progress to diabetes), and smoking status, as well as BP and BMI. In OMH-operated child and youth clinic and day treatment programs we measure quarterly BMI, activity level (60 minutes or more daily for youth aged 13 and above, or for the parents of children under 13), cigarette smoking, and alcohol and drug abuse (in youth 13 or above).
Our findings: We now have the first overall picture of the physical health of individuals in treatment at OMH clinics, day treatment, and hospitals. The preliminary picture, although incomplete, suggests that adult recipients of care at OMH are overweight or obese at levels above the national average, smoke twice as much as the national average, and have significant levels of hypertension. The findings among children thus far demonstrate high levels of overweight/obesity and low activity levels.
Interventions: OMH clinical leadership is working in two areas to address the health problems revealed through our monitoring activities.
• Programming. Efforts include the OMH Wellness Initiative Lifespan, which focuses on diet, activity, smoking cessation, and the use of recovery-focused Wellness Self Management to support healthy lifestyle choices as part of recovery.
• Integrated care. Providing health and mental health care in the same setting by clinicians on the same team is the gold standard. OMH does not expect our psychiatrists to become primary care doctors. They provide specialized care of another sort. On inpatient units, medical specialists are on hand to care for medical issues. In the clinics, however, recipients of care may not have outside physicians to care for their medical problems, or it may be difficult to coordinate with the physicians there are. The integration of mental health services for children, adolescents and adults with primary health care is an important goal for all facilities to pursue. Solutions to integrated care will vary from one facility and one geography to another. We imagine a range of solutions in clinic settings, including the actual provision of primary care by Medical Specialists, co-location with licensed medical clinics, and collaboration with local medical providers. An notable innovation underway is the OMH-funded collaboration of the state Department of Health, the Conference of Local Mental Hygiene Directors, the American Academy of Pediatrics, and the NY State Academy of Family Physicians called Project TEACH (Training and Education for the Advancement of Children’s Health), which provides specialized training, consultation and linkage between primary care physicians (i.e., pediatricians and family physicians) and child mental health professionals.
OMH is committed to both the mental and physical health of our patients. We are working to expand programming and primary care services to improve the health and wellbeing of recipients. Doing so is the right thing to do and a leadership responsibility for our agency.
