One-stop health-care saves money, helps mentally ill regain life

Michael Morrison, 54, used to have money in the bank, a good job and bright prospects.

But in a short period of time, he lost his father, his best friend, the job he'd planned to do forever and the woman he loved.

He found himself clinically depressed, unable to find work and contemplating suicide before a friend urged him to go to the state Department of Social and Health Services for help.

Because Morrison had a psychiatric disability and was unable to work for more than three months, he qualified for General Assistance for the Unemployable (GAU).

In the past, he would have had to search for a mental-health provider who accepted state medical coupons, a difficult task.

But under a pilot program in King and Pierce counties, Morrison was able to receive mental-health treatment as well as medical care and access to social services in one place. For him, it was the Pike Market Medical Clinic on Post Alley, one in a network of nonprofit community health clinics.

Morrison believes the relative ease of access to services helped him stay with his treatment. He now says he's mentally stable, ready to enter training for the merchant marines and get back on his feet.

"Depression can be a pernicious, subtle downward spiral," said Morrison, adding he doesn't know if he would have been able to get well if he'd had to go to several different locations for treatment. "People can tell you you're stupid, or tell you to pull yourself together, but that doesn't help."

GAU, which serves 15,000 people in Washington, is a $200 million state-funded program that provides health care to people who are physically or mentally disabled and have been unemployed for more than 90 days.

While at least 40 percent of recipients have a mental-health condition as their primary diagnosis, the previous plan did not provide care for mental-health services or the treatment of chemical dependencies.

That's because mental-health treatment has not traditionally been considered part of medical treatment and has typically not received the same coverage.

When people with mental-health problems miss doctor appointments or don't take their medications, they are more likely to end up sick, homeless or in the criminal-justice system, said David Kinard, a spokesman for Community Health Plan (CHP).

CHP is a nonprofit insurance company started by community health clinics to serve the state's underinsured and uninsured population, Kinard said.

The pilot program to coordinate treatment of mind and body was implemented by the Department of Social and Health Services and CHP in 2004 to reduce costs, provide better care and help transition people with long-term chronic disabilities into federal-aid programs.

Through the managed-care plan, each patient is assigned a care coordinator who acts as his or her caseworker, overseeing the patient's physical and mental-health treatment and ensuring access to comprehensive health, social and vocational services.

Kinard said the combined care will save the state an estimated $40 million over two years, primarily in reduced hospital and incarceration costs.

"When the state launched the pilot program in managed care, we were able to effectively treat a host of diseases, provide checks and balances on fees, offer preventive care and keep people out of the hospital," Kinard said.

Despite what health-care experts say are promising results for the integrated program, funding for the new GAU program could be on the chopping block as the state faces a growing budget crisis.

Speaker of the House Frank Chopp has defended the new health-care model. "These are people who, quite literally, have nowhere else to go for health care," he said. "This new approach will treat the whole patient, and results in better outcomes for both the patients and the taxpayers."

Christine Clarridge: 206-464-8983 or cclarridge@seattletimes.com