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Aug. 27, 2019

By Chris Arnold, M.D.

In my years of practicing family medicine, I’ve treated patients for everything from broken bones to influenza. One area in which I have little experience is behavioral health care, but that’s about to change.

WellMed has started screening for some of the most common behavioral health disorders that affect our patient population: Depression, anxiety, alcohol and drug abuse and mood disorders. We have already started annual depression screening at WellMed and will soon be screening for other mental illnesses in all WellMed clinics.

Behavioral health is an important component of overall health, yet fewer than half of all adults with a behavioral illness receive help when they need it. Of those who do get help, 60 percent get it from their primary care physician.

While a large part of the problem is a shortage of mental health care providers in the United States, we believe it makes sense that patients get screened for behavioral disorders the same place they are screened for high blood pressure or diabetes – in their primary care physician’s office.

In the past, most people kept behavioral health problems private, mostly because of the stigma attached to the illness. Family members suffering from behavioral health issues were often kept out of sight, sent off to an institution or hidden away at home.

Today, scientists and physicians know much more about how the brain works and the illnesses that affect it, and have developed treatments that can help. Still, many people continue to feel ashamed when they, or someone they love, have a behavioral health disorder.

Being screened during a visit with your primary care physician is a convenient, private way to make sure you are taking care of your behavioral health. Using a series of questionnaires during your regular office visit, a medical assistant will ask you about your energy level, sleep patterns, appetite and other topics. The answers to these questions can help your health care provider diagnose problems such as anxiety or depression, both very common illnesses in older adults.

If your doctor thinks you need help for a behavioral disorder, they will talk with you about different options, including medication and talk therapy.

Depending on what the level of care you need, your physician may refer you to a mental health professional outside of the office, including:

    • Psychiatrists – Medical doctors or doctors of osteopathy who are trained in behavioral health. They can provide psychotherapy and prescribe medication.


    • Clinical psychologists – Professionals with advanced degrees in behavioral health who can diagnose disorders, conduct psychological testing and provide psychotherapy. Clinical psychologists cannot prescribe medication.


    • Licensed professional or mental health counselors – Counselors with advanced degrees in counseling who can diagnose and treat cognitive behavioral, psychodynamic and interpersonal therapy and mostly specialize in psychotherapy, marriage and substance abuse counseling.


    • Licensed Certified Social Workers — Those who work in a clinical setting can offer one-on-one psychotherapy and treatment recommendations. They cannot prescribe medication.


    • Psychiatric or mental health nurse practitioners — Professionals who have a master’s degree or a nurse practitioner degree who can diagnose and perform psychotherapy. Psychiatric/mental health nurse practitioners can prescribe medication and provide emergency psychiatric services.


    • Psychiatric and mental health nurses – Psychiatric nurses have a bachelor’s or master’s degree in nursing and can assess and treat psychiatric illnesses.


If you or a loved one is experiencing a behavioral health problem, help is available. Behavioral health illness can quickly degrade your quality of life, so don’t hesitate to ask about getting help from someone you know and trust – your primary care physician.

Dr. Chris Arnold is a senior medical director at WellMed Medical Group. Dr. Arnold received his degree in biomedical science from Texas A&M University in College Station, Texas and his medical degree from the University of Texas Health Science Center in Houston, Texas. He completed his Family Medicine residency at the Corpus Christi Family Medicine Residency Program in Corpus Christi, Texas.

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