History of intervention: Kirk Strosahl, PhD developed a primary care behavioral health consultative model of care with solid and grounded integrative care research.
Issues addressed: An organized approach to intervening utilizing a multi-disciplinary approach—medical providers (PCP), nursing support staff, behavioral health consultants (BHC), health educators, pharmacy, and dental services. The area of focus is the relationship and function of the medical provider, and the behavioral consultant, working together within an outpatient community health center (FQHC).
Goals/ objectives: Best practice utilizing brief behavioral health assessment and intervention within primary care settings promoting:
- Improved health outcomes for chronic, co-occurring disorders (medical and psychological conditions).
- Producing integrative care data that speaks to the use of co-locating PCP and BHC in the same clinic focusing on coordinated care data that reflects reduction in healthcare cost/medical cost offset in co-treating the patient population seen in primary care.
Implementation: Southwest Virginia Community Health Systems, Incorporated, a federally qualified community health organization located in rural Southwest Virginia region operating six outpatient community health clinics. SVCHS utilizes a “level of care” continuum which attempts to address different behavioral health needs through a horizontal pathway that speaks to the general primary care patient population, for example, diabetes and depression, cardiovascular and depression, and COPD and depression/anxiety, etc. as well as a vertical pathway that speaks to the more complicated behavioral health needs such as major depression, recurrent, bipolar disorder, and schizoaffective disorders, etc. This integrated program is designed for high frequency primary care populations. It involves specialized medication regimes prescribed by the primary care provider and tailored behavioral treatment approaches provided by the behavioral health provider.
In order to develop an optimal integrated behavioral health primary care system, there are key components that need to take place as follows: 1) population based care framework that allows co-location of behavioral health consultants within the clinic walls, 2) identifying the patient needs which in turn allow the primary care team (PCP-BH integration) to develop critical pathways that speak to each patients’ medical condition from a holistic approach (mind, body, and spirit), and foremost, to be consistent with primary care philosophy.
Reference: Bill McFeature, Tom Pierce. Primary care Behavioral health Consultation Reduces Depression Levels Among Mood- Disordered Patients. Journal of Health Disparities for Research and Practice, Vol5, Issue 2, 2012.
Bill McFeature, PhD, Director, Integrative Behavioral Healthcare Services
Southwest Virginia Coummunity Health Systems, Inc.
319 Fifth Avenue, PO Box 729
Saltville , Virginia 24370-3418
Primary Care and Behavioral Health Integration Manual