The words “integrated” and “integrative” are often used interchangeably, but in the context of mental health, they have very specific and very different meanings. Integrated care refers to collaboration between medical and behavioral healthcare providers, while integrative care blends clinical modalities with complementary approaches such as yoga, meditation, and nutrition therapy.
Separately and together, these models of care seek to address the whole, multidimensional person—treating the full spectrum of physical, emotional, mental, social, spiritual, relational, and environmental influences that impact an individual’s health. At Newport Healthcare, our philosophy of care incorporates both integrated and integrative treatment, yielding industry-leading outcomes.
Integrated Care: Experts Working in Collaboration
As defined by the National Institute of Mental Health (NIMH), integrated care “blends the expertise of mental health, substance use, and primary care clinicians, with feedback from patients and their caregivers. This creates a team-based approach where mental healthcare and general medical care are offered in the same setting.”
Historically, behavioral and mental healthcare have been separated from the medical, or primary care, system. A patient diagnosed with depression and heart disease, for example, would be sent to two specialists who would typically not communicate with each other. A teenager with an eating disorder would be treated for malnutrition by her doctor and would go to a therapist for her co-occurring anxiety and depression; the two providers might never speak. (This is still the case for most patients, even though the Institute of Medicine concluded in 1996 that having these separate systems of care was leading to poorer health outcomes and higher spending.)
Know the Facts
As defined by the National Institute of Mental Health (NIMH), integrated care “blends the expertise of mental health, substance use, and primary care clinicians, with feedback from patients and their caregivers. This creates a team-based approach where mental healthcare and general medical care are offered in the same setting.
This system sees physical and mental health as separate and distinct. However, as research on the mind-body connection shows, the two are inextricably intertwined. The groundbreaking Adverse Childhood Experiences (ACE) Study conducted in 1998 provided scientific validation for this understanding, showing that individuals who had experienced childhood trauma were at higher risk not only for alcoholism, drug abuse, depression, and suicide attempt, but also for heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease.
The Case for Integrated Care
NIMH notes three important reasons why the model of integrated care is beneficial:
- More than 50 percent of treatment for common psychiatric disorders takes place in primary care settings, such as doctor’s offices, where providers may not be as trained or knowledgeable about mental healthcare
- Adults with serious mental health conditions and substance abuse issues are also more likely than the general population to have chronic physical illnesses
- Patients who report higher rates of physical health problems also have higher rates of mental health issues.
Randomized controlled trials show that integrated care is more effective, creates a more positive experience for patients, and reduces costs. Regarding adolescents and young adults in particular, a review of research on integrated care for these age groups concluded that “integration of behavioral health into primary care settings has the potential to address [treatment] barriers and improve outcomes.”
Integrated Care at Newport
At Newport Academy, Newport Healthcare’s teen treatment program, and Newport Institute, our program for young adults, every patient is assigned their own treatment team that includes both medical and behavioral/mental health specialists. Hence, psychiatrists, MDs, and nurses work collaboratively with family and individual therapists, experiential therapists, recovery counselors, and dieticians, among others.
Together, they design a tailored treatment plan customized for the needs of each teen or young adult and set treatment goals that take into account all aspects of the patient’s health and well-being. Moreover, the team gleans insights from family and loved ones, as well as referring professionals.
Integrative Care: Blending Conventional and Complementary Modalities
Integrative mental healthcare combines conventional treatment, such as Cognitive Behavioral Therapy (CBT) and medication, with complementary modalities (also known as alternative or holistic modalities). These approaches encompass a wide range of interventions, from vitamin and mineral supplements and biofeedback to mind-body practices such as yoga therapy, mindfulness training, acupuncture, and energy therapies.
The Evidence for Integrative Care
A growing body of research supports the efficacy of complementary modalities in treating anxiety, depression, trauma, and other mental health conditions. From physical exercise to meditation, these approaches have been shown to produce significant positive impacts on mental health symptoms. Therefore, evidence-based treatment is not limited to one type of intervention—it can include both conventional and non-conventional approaches that have been scientifically validated.
Furthermore, studies show that a widespread adoption of integrative care in the mental health field will—like integrated care—improve outcomes, enhance patient satisfaction, and be more cost-effective.
Integrative Care at Newport
At Newport Academy and Newport Institute, patients’ daily schedules include a variety of evidence-based modalities, both clinical and complementary, which may shift over time in response to what is most effective for them. Moreover, integrative care is reflected in multiple aspects of treatment and daily life during residential care. For example, we use the “meal as medicine”—incorporating nutrients proven to enhance mental health into each lovingly prepared meal. Teens and young adults do mindfulness and gratitude practices, and physical exercise and time in nature are woven into their days through modalities such as Adventure Therapy, Equine-Assisted Therapy, and horticultural therapy in our on-site gardens.
Integrative care not only addresses different aspects of each individual, it also provides multiple doorways for clients—particularly important for young people who may be initially resistant to treatment. While one teenager may find CBT especially helpful for reframing negative thoughts around body image, for example, another teen or young adult may have meaningful experiences of trauma release through yoga, art therapy, or music therapy. In turn, these experiences create a greater openness to other types of interventions, increasing the likelihood that treatment will be successful, and healing will be long term and sustainable.