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Mental Health Integration Program

The Mental Health Integration Program (MHIP), supported and administered by the Community Health Plan of Washington  in partnership with Public Health -Seattle and King County , integrates mental health screening and treatment in a collaborative care model (CoCM), including psychiatric case review and consultation. MHIP collaborative care teams in Washington State safety-net primary care settings serve diverse Medicaid and uninsured populations. Since MHIP’s inception in 2007, over 50,000 individuals have received integrated mental health services. In 2007 it began as a state-funded, two-county pilot for high risk uninsured adults in King and Pierce counties, but MHIP expanded statewide in early 2009 to include over 130 primary care clinics.

MHIP uses a patient registry (CMTS) to track and measure patient goals and clinical outcomes, and facilitate treatment adjustment if a patient is not improving as expected. MHIP also utilizes pay-for-performance mechanisms to support model fidelity and prioritize patient outcomes. Training and workforce efforts for this project focus on the whole team and all providers are trained on the fundamentals of CoCM. Telehealth can improve access to specialty consultation for patients with common mental disorders or substance abuse by linking specialists at academic or regional health centers with healthcare providers in underserved areas. Compared to in-person care, most studies have shown telepsychiatry to be reliable in diagnosing and treating an array of conditions across the age span from children to the elderly.

Impact summary:

  • Psychiatric telehealth consultations in primary care have had an enormous impact on reaching patients with mental health disorders when part of a Collaborative Care initiative.
  • In Washington State’s Mental Health Integration Program (MHIP) alone, consulting psychiatrists in 2011 provided more than 10,000 telephonic case reviews and treatment recommendations for patients with mental disorders, chronic pain, and/or substance abuse disorders throughout the state of Washington.
  • The cost is similar to seeing a patient face to face, but is cost-effective as it requires less personnel.

In the Mental Health and Opioid/Pain Management Consultation project, psychiatrists support and collaborate with rural healthcare providers using telehealth-based specialty consultations and provider/patient education for patients with common mental disorders or opioid abuse. Services include:

  • Video teleconferenced patient evaluations
  • Recommendations to patients’ local primary care providers
  • Systematic caseload supervision
  • Access to an array of educational offerings via video teleconferencing

Telehealth supports primary care providers by reducing provider isolation, allowing them to provide mental health care in their clinics rather than sending patients to a distant mental health center, and by providing an opportunity to learn how to treat patients by participating in consultations and receiving case management support. Telehealth can also provide training opportunities for developing a workforce of people who can effectively treat common mental health disorders.

Population: Rural

Links:

Date: 2020