Establishing an integrated care practice in a community health center.

Abstract

In a progressively complex and fragmented health care system and in response to the need to provide whole-person, quality care to greater numbers of patients than ever before, primary care practices throughout the United States have turned their attention and efforts to integrating behavioral health into their standard service-delivery models. With few resources and little guidance, systems struggle to gather the support required to establish effective integrated programs. Based on first-hand experience, we describe a working integrated primary care model, currently utilized in a large community health center system in Colorado, that encompasses universal screening, consultation, psychotherapy, and psychological testing. With appreciation for the way an organization's unique circumstances inform the best approach for that particular organization, we highlight the clinicallevel and system-level variables that we consider necessary for successful practice development and address how our behavioral health program operates despite funding limitations. We conclude that organizations that aim for integrated primary care must mobilize leadership to implement systemic changes while making difficult decisions about program development, financing, staffing, and interagency relationships.

The Affordable Care Act: policy predictors of integrated care between Hispanic-serving and mainstream mental health organizations

“…Health insurance providers, including State Medicaid Plans, did not allow health care organizations to bill for more than one type of services (e.g., behavioral and primary care) within the same day [ 39 , 40 ]. This forced organizations not to bill Medicaid, turning instead to private insurers to cover these integrated services [ 41 ].…”

Client Satisfaction and Quality of Life at Primary Healthcare Clinics and Psychiatric Hospitals in the Eastern Province of Saudi Arabia

“…Hence, the patients' bill of rights (PBR) publicized by the Saudi Ministry of Health (MOH) [57] has led to a stronger call for providing an insight into awareness and knowledge of patient's rights such as right to confidentiality and privacy [58]. To reduce stigma, Angantyer et al [6] perceived brief therapy at PHC as less stigmatizing for clients, especially when it is conducted by a qualified psychotherapist [59]. Other programs to fight against negative attitudes and beliefs about mental illness can be implemented via public awareness campaigns, media messages targeting documented stigma and discrimination [60], and well trained psychologists who have knowledge of PHC strategies and all techniques important for providing effective psychotherapy [19].…”

From Distress Guidelines to Developing Models of Psychosocial Care: Current Best Practices

“…In other words, members of the psychosocial team should predictably respond to elevated or questionable screening results within a prescribed and, ideally, a short amount of time. The advantage to developing a systematized pattern of rapid and reliable response is that it ensures equitable provision of care, diminishes the likelihood that needs will be overlooked, and reduces concerns or reluctance by the medical staff and others about having to identify and manage psychological, emotional, and social issues on their own (Auxier, Farley, & Seifert, 2011). A comprehensive assessment includes gathering, analyzing, and synthesizing information about the presence of psychosocial issues that can challenge a patient's capacity for making health care decisions, managing illness, or maintaining quality of life.…”