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The Power of Positive Reinforcement and Personal Strength

One Consumer’s Experience of Integrated Care Translates to a Healthier, Brighter Future
by Laura Galbreath, Deputy Director of SAMHSA-HRSA Center for Integrated Health Solutions ����January 31, 2012

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Research over the past decade has revealed ominous health risks associated with mental illnesses and addictions. Individuals living with these conditions are at risk of premature death from complications from untreated, preventable chronic illnesses like hypertension, diabetes, obesity, and cardiovascular disease. Consider that 50% of people with serious mental illness smoke, 42% are obese, and as many as 80% do not exercise regularly. Obesity and sedentary behavior are major risk factors for myriad diseases and reduced life expectancy. Facing such grave statistics, how can we make a meaningful difference? Specifically, how do integrated primary and behavioral health organizations translate existing knowledge into health promotion interventions that measurably improve health outcomes?

To start, we must think about these issues in the context of the people we serve. Instead of thinking, “how can we help our clients stop eating poorly?” we must ask, “How can we help Joe meet his goal of eating one vegetarian meal a week and walking to and from the coffee shop each day?”

Linda Andersen received such individual attention at the Greater Cincinnati Behavioral Health Services (GCBH). A grantee, GCBH received funding from SAMHSA to integrate primary care into their behavioral health practice. When Linda came to GCBH, she was struggling with various chronic health problems such as bipolar disorder, diabetes, and high cholesterol. She was used to hearing doctors tell her what she couldn’t eat and what she shouldn’t do. She often heard, “you are going to die.”

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Today, Linda has lost 42 pounds, reduced her insulin levels by more than 70%, and gotten off one of her diabetes medications. She attributes her success in part to the positive reinforcement she received at GCBH. “The nurse care manger never talked down to me or said that I couldn’t do anything.” The strength-based, holistic care Linda received at GCBH empowered her to make meaningful changes in her life such as learning to recognize hunger and fullness, eating healthier foods, and the power of walking for fitness.��

Linda now leads numerous GCBH wellness programs as a peer support manager. As part of its suite of services, GCBH offers emotional eating groups, exercise classes, stress reduction, nutrition classes, and more. GCBH also offers incentives -such as hygiene and beauty products donated by local businesses – to those who accomplish the goals.

So, while researchers continue to identify best practices in health promotion for people with mental illnesses and addictions, a growing number of behavioral health and primary care centers are already providing these needed services. In fact, all organizations participating in the PBHCI program provide wellness services. They know that despite grave statistics and multiple barriers, optimum health and recovery are possible.

For more information on wellness or for technical assistance from CIHS, visit . For additional information on wellness and SAMHSA’s efforts, visit .