Area of application for integrated behavioral health
Promoting healthy behavior and protective factors
Mental health and substance abuse conditions
Medical conditions with intertwined behavioral health factors
Complex situations: clinical, health system and patient factors needing team-based care
A. Identification or screening
Promotion of health behavior change in chronic disease or prevention;
Screening for MH/SA conditions that can be understood and treated more or less independently of other health concerns
Screening for complicated/uncontrolled medical conditions intertwined with MH/SA conditions
Identification of pts with physical symptoms or common PC complaints not fully explained via disease processes
Detection of care delivery patterns in records and claims associated with:
• Over utilization
• Unfocused utilization
• Unplanned visits, ER, hosp, urgent care
• Many failed services
• Distrustful pt-clin rel
• Pt unhappiness with care—feeling stuck
• Provider feeling stuck
Behavioral risk assessment for health and functional status
Methods: health risk assessments; behavioral/wellness checklists; developmental screening
Methods: basic MH/SA screening tools
Methods: basic MH/SA screening tools in context of medical condition treatment
Methods:
• General sx checklists
• Problem lists
• Recurring visits
• Basic MH screening
B. Assessment
Interview and planning by nurse, BH consultant, physician, care coordinator, health coach
Referral to BH consultant for evaluation
Synchronized medical and BH care planning and goal-setting
Incorporation of BH consultant with physician in evaluation and care planning
Reading records with patterns above to find out what is going on; involve patient as appropriate
C. Treatment
Self-management plan guided by motivational interviewing or other adjusted goal-setting
BH treatment in or outside PC clinic—with or without close involvement from physician
Carrying out single coordinated care plan in shared EHR with treatment adjusted to targets
BH treatment in close coordination with physician or jointly
Carrying out single coordinated care plan in shared EHR with treatment adjusted to targets
Strategies for Initial Detection of Behavioral Health Needs in Primary Care
Patient Engagement, Quality of Life, and Social Support
Promoting prevention and wellness are cornerstones for primary care health systems, and many who present with chronic diseases or health conditions such as fatigue, insomnia, or chronic pain could benefit from integrated behavioral health. Patients with tobacco abuse, diabetes, obesity, asthma, chronic pain, insomnia, or dementia are commonly seen in primary care settings and may benefit from behavioral health interventions such as motivational interviewing, resiliency training, or problem-solving skills. Yet, there are no well-established standardized identification tools that alert providers to behavioral health interventions that may enhance a patient’s ability to manage or cope with a life stressor, health condition, or disease, much less enhance wellness and resiliency.
Related posts:
The State of the Evidence for Integrated Behavioral Health in Primary Care
Collaborative Partnerships Within Integrated Behavioral Health and Primary Care
Implementing Clinical Interventions in Integrated Behavioral Health Settings: Best Practices and Essential Elements
Integrated Behavioral Health in Public Health Care Contexts: Community Health and Mental Health Safety Net Systems
Screening Measures in Integrated Behavioral Health and Primary Care Settings
Integrated Behavioral Health and Primary Care: A Common Language
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