Why Minnesota families need whole-person behavioral healthcare

I’ve spent much of my career sitting across from parents who are exhausted before they even get to talk about the problem that brought them in. Not exhausted by their child’s behavioral healthcare needs, necessarily, but by the sheer number of doors they’ve had to knock on to get help.

One provider for therapy. Another for a psychiatric medication check. A separate referral for the asthma that keeps landing their child in urgent care, and yet another call to figure out whether insurance will cover any of it. By the time they sit down with me, they’ve often told their story four or five times to four or five different people, and nobody in those rooms was talking to each other.

That disconnect isn’t unique to Fraser or even to Minnesota — it’s structural. Mental health, physical health and the everyday supports families rely on, like housing help or school coordination, have historically been treated as separate systems with separate intake forms and separate waiting rooms, and multiple staff. But for families living it, there’s no separation.

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A child’s anxiety doesn’t pause while you wait six weeks for a psychiatry appointment. In fact, the wait could exacerbate anxiety resulting in physical symptoms as the child begins to feel sick and withdraws from everyday activities. A teenager’s asthma doesn’t care that the pulmonologist and the therapist have never spoken and no one has checked whether this neurodivergent adolescent is using their inhaler correctly.

We’re learning, more clearly than ever, how tightly the mind and body are connected. People with depression are roughly 40% more likely to develop cardiovascular disease. Adults with diabetes are two to three times more likely to experience depression. Among adults with mental illness, more than two-thirds also live with at least one chronic physical condition.

According to the Centers for disease Control and Prevention, children with adverse childhood experiences (ACEs) have a higher likelihood of developing chronic diseases, cognitive and behavioral challenges, and substance use disorders in later life and even lowered life expectancy. These aren’t coincidences; it’s the same nervous system, the same stress hormones, showing up in more than one place at once.

We see this mind-body connection especially in children with autism, who are diagnosed with asthma at meaningfully higher rates than their neurotypical peers. They’re also more likely to have multiple health conditions at the same time, not just one diagnosis, but several that often overlap and can be easy to miss if no one is looking at the full picture.

A child who is struggling to breathe is also going to struggle to regulate emotionally. A child whose GI symptoms go unaddressed is going to have a harder time with a behavioral intervention that assumes their body feels fine. Treat these as unrelated issues assigned to unrelated providers who never compare notes, and we end up managing symptoms without ever getting close to the cause, and more importantly, without making a meaningful difference.

This is part of why the shift toward whole-person, integrated behavioral health care matters so much right now. Minnesota has been expanding a model called the Certified Community Behavioral Health Clinic, or CCBHC, which requires organizations to build mental health, physical health screening, substance use support and care coordination into one system rather than a referral chain.

Fraser recently earned this designation, and the process has changed how we think about care. It means a nurse can flag a health concern during intake instead of it going unnoticed for years. It means a care coordinator can help a family navigate a housing crisis without that falling entirely on an already stretched therapist. It means that when a clinician wonders how a client’s diabetes might be affecting their mood, there’s someone down the hall who can actually answer. This integration creates a lens that expands our thinking about how to support care to families across systems.

None of this happens instantly, and it isn’t a fix for every gap in the system. Families still face real barriers like insurance authorization delays, workforce shortages and stigma that keeps people from reaching out in the first place. Research shows that people struggling with substance use often wait a decade or more after symptoms begin before they get treatment.

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We never know which interaction with a professional is the one that helps prompt next steps into intervention. But, unless we are engaged in working together, there are many more missed opportunities to shorten the journey to treatment. Integration doesn’t erase those obstacles, but it does mean fewer families have to serve as the sole coordinator of their own child’s care, piecing together a treatment plan from providers who’ve never spoken to one another.

What I’d ask Minnesota families, providers and policymakers to consider is this: When we talk about improving access to mental health care, access isn’t only about how many providers exist. It’s about whether those providers are working from the same information, toward the same goals, for the same family.

Whole-person care isn’t a new philosophy. It’s a return to a simple truth: People aren’t a collection of separate diagnoses to be treated in separate rooms. The more our healthcare system reflects that reality, the less families will have to connect the dots between providers, advocate for coordinated care on their own and find the treatment that makes a meaningful difference.

Pat Pulice is senior vice president and chief clinical officer at Fraser, a Minnesota-based provider of autism and mental health services for children and families.

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