Primary Care Prescribing Psychologists in the Indian Health Service
Some of the largest health care disparities are those related to services for American Indians and Alaska Natives (AI/ANs), who show significantly greater prevalence for diabetes, coronary heart disease, smoking, obesity, heavy alcohol use, depression, and PTSD than the general population. Given the recognition of the behavioral components of all of these conditions, the Indian Health Service, the federal agency responsible for providing comprehensive health care services to AI/ANs, has been focusing on increasing the integration of behavior health and primary care. One innovation has been to hire prescribing psychologists on primary care teams. This paper describes the role of a prescribing psychologist on three treatment teams at an IHS facility in Montana. Prescribing psychologists in the Indian Health Service can serve as valuable members of comprehensive care teams, providing exceptional wrap-around care for some of our most vulnerable and underserved citizens. This model could be an example of how a prescribing psychologist could contribute to primary care clinics in a variety of other settings.
KeywordsPrescribing psychologist Primary care Co-morbidities Indian Health Service Behavioral health Integrated care
- Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2010). Health characteristics of the American Indian or Alaska Native adult population of the United States, 2004–2008. National health statistics reports, number 20. Washington, DC: US Department of Health and Human Services.Google Scholar
- Centers for Disease Control and Prevention, HHS. (2009). WISQARS database. www.cdc.gov/injury/wisqars/index.html.
- De Hert M., Correll C. U., Bobes J., Cetkovich-Bakmas M., Cohen D., Asai I., et al. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10, 52–77. www.ncbi.nlm.nih.gov/pubmed/21379357.
- Druss B. G. & Walker E. R (2011). Mental disorders and medical comorbidity. Robert Wood Johnson Foundation, Research synthesis report no. 21, February 2011. www.policysynthesis.org.
- Gatchel, R. J., & Oordt, M. S. (2003). Clinical health psychology and primary care: Practice advice and clinical guidance for successful collaboration. Washington DC: American Psychological Association.Google Scholar
- Holm, J. E., Vogeltanz-Holm, N., Poltavski, D., & McDonald, L. (2010). Assessing health status, behavioral risks, and health disparities in American Indians living on the northern plains of the U.S. Public Health Reports, 125, 68–78.Google Scholar
- Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2009). Integrated behavioral primary care: Step-by-step guidance for assessment and intervention. Washington DC: American Psychological Association.Google Scholar
- Indian Health Service. (2011a). IHS year 2011 profile, July 15. Rockville, MD: Indian Health Service. http://www.ihs.gov/PublicAffairs/IHSBrochure/Profile2011.asp.
- Indian Health Service. (2011b). Fiscal year 2012: Justification of estimates for appropriation committees, July 26. Rockville, MD: Indian Health Service. http://www.ihs.gov/nonmedicalprograms/budgetformulation/documents/FY%202012%20budget%20J.ustification.pdf.
- National Center for Health Statistics, DHHS. (2007). Health, United States, 2007, with Chartbook on trends in health of Americans (Table 61). www.cdc.gov/nchs/data/hus07.pdf.
- Surgeon General, HHS. (2001). Mental health: Culture, race, and ethnicity, a supplement to mental health: A report of the surgeon general. Washington, D.C.: Department of Health and Human Services. http://www.ncbi.nlm.nih.gov/books/NBK44242/.
- Vogel, M. E., Kirkpatrick, H. A., Collings, A. S., Cederna-Meko, C. L., & Grey, M. J. (2012). Integrated care: Maturing the relationship between psychology and primary care. Professional Psychology: Research and Practice, 43, 271–280.Google Scholar