Central City Concern to Integrate Physical, Mental Health

The agency received $8.95 million in federal stimulus grants to build a new clinic

April 7, 2010 -- Conversations are under way at Central City Concern to develop a medical clinic that integrates physical and mental healthcare.
“It’s probably rather unique to merge a major primary healthcare center with a major community mental health center,” said Ed Blackburn, executive director of the social service agency.
The clinic will be located at NW Burnside Ave and NW Broadway in downtown Portland where an abandoned Burger King building is now located. Ground is expected to be broken in July, with a three-floor building opening the following year.
Central City Concern received an $8.95 million federal stimulus grant to pay for half of the construction costs. The remainder will come from tax credits and bonds. 
The clinic will be more like a medical home. “We want it to be a healing center,” Blackburn said. It's just not clinical. It's not antiseptic. It's not in and out. We want people to feel a healing more complete than just medicating them or feeling an injection.”
Once built, the Old Town Clinic will coordinate services with the 12th Avenue Recovery Center, an outpatient mental health and addiction treatment program now located at SW Washington Avenue and SW 12th Avenue.
By integrating care, patients will receive higher quality services, enabling them to fully heal rather than just be treated for a specific illness, said Dr. Rachel Solotaroff, medical director of Old Town Clinic. “This is probably the way people were meant to be taken care of.”  
One medical team already provides such care, said Dr. Phil Shapiro, the Recovery Center’s medical director. “It’s a tremendous opportunity to do things better.”  
The new clinic will offer a holistic form of healing that meets a person’s biological, psychological and spiritual needs. Educational classes, social events, physical rehabilitation, yoga and acupuncture will also be available.
About 1,600 patients are expected to receive treatment from three medical teams comprised of a nurse, two primary care doctors, a behavioral care provider and two medical assistants. 
Most patients are homeless, uninsured or covered by Medicaid, and suffer from co-occurring physical conditions such as diabetes, heart disease and high blood pressure; severe mental illnesses like schizophrenia or major depression; and addictions related to substance abuse.
Frequently people with multiple medical problems are referred to different care facilities and providers. Since many are homeless, they’re often unable to keep appointments or get from one facility to the next. “Things get very disintegrated and fragmented,” Shapiro said.
With a team approach, providers will gain a better understanding of a person’s medical history and background. “They'll be cooperating in ways that are more extensive than before,” Blackburn said.
It’ll also be much easier for people to receive appropriate medications for a physical and/or mental disorder, Solotaroff said. “One’s emotional and psychological states affect their physical well-being. And one’s physical well-being affects their emotional or psychological health. It shouldn’t be such an artificial divide.”
Integrating physical and mental health has become a national trend, Shapiro said. “There’s a return to integrate the pieces again. If all of it’s done in the same building, it’s going to be easier for the client and more efficient for the staff.”
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