| Integrating a Behavioral Health Program in a Primary Care Clinic A
Rural Mental Health Success Story: Family
HealthCare Network (FHCN) is a primary care clinic with ten sites
located in Tulare County, in California’s rural San Joaquin
Valley. FHCN exists to provide quality healthcare to everyone
in the communities we serve. Statistics show that some 70 percent
of patients seen in a primary care setting have some type of mental
health or psycho-social issue adversely affecting their physical
well-being. Many of our patients are poor, many are migrant workers,
many are undocumented, and face cultural, linguistic and financial
barriers when trying to access mental health services. Five years
ago, FHCN decided to do something about it. FHCN began an Integrated Behavioral Health program that allows patients access to behavioral health services on site, usually as part of their medical visit. Behavioral health factors and medical factors are not separate in our bodies. Regardless of diagnosis or multiple diagnoses, integrated primary behavioral health care produces better patient outcomes, reduced cost, and satisfied customers, making the community health center and community clinic integration model a logical, full partner in the health care system. The way it works is this: Primary Care Providers (PCP) at FHCN who are concerned about the effect that a patient’s mental health is having on their physical health, or, conversely, are concerned that a patient’s physical health will adversely impact the patient’s emotional well-being, will page a Behavioral Health Consultant. The consultant, who is a Licensed Psychologist, Licensed Clinical Social Worker or a Registered Psychologist, will come into the exam room to meet with the patient about the PCP’s concerns. The Behavioral Health Consultant will do a rapid but thorough assessment of a patient’s symptoms, functional impairment and coping resources, make a diagnosis when appropriate, and work with the patient and medical provider on a treatment plan that will help move the patient toward better physical and emotional health. Treatment plans typically involve teaching a set of cognitive and behavioral skills, with the goal being to increase function and reduce symptoms. Integrated Behavioral Health differs from traditional psychotherapy in several important ways, and not every patient fits the behavioral health model. Some patients, for example, those with deep emotional wounds, or an extremely high level of psychopathology will still need to be referred to a therapist, and in these cases, the Behavioral Health Consultant will help the patient transition to the appropriate agency. The
most serious issue affecting full integration of primary and behavioral
health services in California is the inability to bill both medical
and behavioral health visits that occur on the same day and receive
reimbursement for both. By working with various state organizations
and state officials our intent is to overcome this barrier by
encouraging reimbursement for two visits in the same day. For
many patients, especially those who will not seek or accept traditional
mental health services because of shame, stigma, cultural influences,
financial or other barriers Integrated Behavioral Health is just
what the doctor ordered! |
|||
3720
Folsom Boulevard, Suite B Sacramento, CA 95816 ::
T 916.453-0780 :: F 916.453-0783 |
|||
