December 15, 2017

Integrating Behavioral Health into Primary Care

December 2017

Huddled healthcare workers

As our name indicates, integrated healthcare is what we’re all about. For the past two years, IHP has had a strong focus on integrating behavioral health into primary care. Practices from both behavioral health and primary care have partnered together to work on improving bidirectional communication and access to behavioral health services.

 

The Integrating Behavioral Health into General Medical Care initiative focuses on improving processes and communication between behavioral health specialists, primary care physicians, and other clinicians to result in improved outcomes for patients and reduced costs. 

Studies have shown that there is a link between depression and chronic illnesses such as diabetes.  Additionally, the coexistence of depression and diabetes in patients is associated with 4.5 fold higher healthcare expenditures compared to patients without depression; however, successful depression treatment has been associated with lower subsequent healthcare utilization and expenditures¹. 

Due to the strong link between medical illness and mental illness, it is crucial that medical and behavioral health specialists collaborate with one another to improve timely access to care and to provide efficient bidirectional communication.  Treatment plans and medication information are of particular importance when co-managing medical and mental health issues. 

Two years ago, IHP conducted a survey of its provider offices to assess their satisfaction with behavioral healthcare management.  The results showed a high dissatisfaction with the following:  timely access to behavioral health services, knowing which services are available in the community, and bidirectional communication between medical and behavioral health providers.  In response to this information, IHP’s first step was to bring together a cohort of primary care and behavioral health specialists from the community.  The cohort began brainstorming action items to address these issues.  The next step was to identify and collect information for the various types of behavioral health-related services in the community.  After contacting each service, IHP held a Calhoun Area Behavioral Health Expo where area behavioral health specialists and a multitude of healthcare professionals and community agencies came together to network and learn more about the need for collaboration to improve patient outcomes.  Subsequently, IHP overhauled its Community Resource Guide and vastly expanded the behavioral health resources section.  IHP’s care managers and practice coaches were instrumental in ensuring the services were all-inclusive and that the guides were shared among its provider offices and with patients.

The members of the Behavioral Health Cohort recently completed process mapping to create a visual look at their processes related to behavioral health referrals and to assess targeted areas in need of improvement.  The group is currently finalizing the use of a “universal” release of information form as well as a standard process for getting patient consent to allow sharing of relevant medical and behavioral health information.  This information sharing is necessary for each specialty type to provide comprehensive care while ensuring safety and continuity of care for patients.  Some of the practices are also focusing on how to integrate behavioral health services on-site in primary care practices while others are pursuing alternate ways of accessing real-time services for patients in crisis. 

For more information regarding the Behavioral Health Cohort, please contact Chelsea Hauschild, Practice Coach, at 269-425-7114. 

 

¹ Egede LE, Zheng D, Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes.  Diabetes Care.  200;25(3):464-70