Successful Integrated Care: Behavioral health in primary care practices

New models for the delivery of behavioral healthcare services are emerging just as new payment models for all healthcare services are being explored. Behavioral Healthcare Magazine recently reported on the integration of behavioral health providers into primary care settings by Christiana Care Health System.

Christiana Care is an organization that already uses evidence-based care across their organization. They had previously embedded psychologists in their neurology, cardiology and cancer departments. Now they have added psychologists and social workers into their primary care practices.

Linda Lang, M.D., chair of the department of psychiatry at Christiana Care makes the following suggestions for organizations considering such a move.

Integration best practices

For fellow health systems considering whether to integrate behavioral healthcare into their primary practices, Lang offers the following advice:

Be flexible. For behavioral health specialists who are used to sitting in an office, working in a primary care setting can be a jolt.

“It’s a much more fast-paced, ‘anything can happen throughout the day’ kind of thing,” Lang says.

Define expectations. Primary care and behavioral health specialists who will be collaborating need to clearly define their respective roles in their working relationship.

“Helping primary care doctors understand what they can expect from the behavioral health provider is important,” she says. “Some primary care doctors really want to manage their patients fully. Others prefer to have a collaborative approach.”

Understand the value of staff buy-in. When presented with the integrated model, caregivers at Christiana Care were receptive, which helped with implementation.

“We were able to get our psychologists and social workers to sign on for something new and exciting, knowing we were meeting the needs of folks in a much different way,” Lang says. “Training and buy-in are very important for this to be successful. There are some of us who have been doing a certain model for a long time. We have a group of people here interested in learning new models of care. Medicine changes all the time. We practice an evidence-based way of delivering all care, and there’s lots of evidence to show this works better. We all are of similar mindset that we want to do what’s best for the patient. We want to grow and learn new techniques.”

Working in a traditional medical setting is not yet usual for behavioral health specialists who are not psychiatrists or nurse practitioners. It is clear that this is one model for comprehensive patient care that will expand.

What do you think it will take for behavioral health and primary care practitioners to find comfortable and useful ways of practicing together? Please share your comments below.