Leveraging Behavioral Health Expertise: Practices and Potential of the Project ECHO Approach to Virtually Integrating Care in Underserved Areas

Hager, Brant W.; Hasselberg, Michael J.; Arzubi, Eric; Betlinski, Jonathan; Duncan, Mark; Richman, Jennifer; Raney, Lori

doi:10.1176/appi.ps.201700211

Cited by 35 publications

(26 citation statements)

References 10 publications

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“…To overcome this, alternative care models integrate mental health and substance use treatment. One robust model is the Behavioral Health ECHO (Extension for Community Healthcare Outcomes) program that uses videoconferencing to provide consultation regarding psychopharmacological and non-pharmacological treatments to primary care teams and community health workers (Hager et al, 2018). Another approach is Behavioral Health Homes that provide co-located primary care and wellness services in community mental health centers (Viron, Zioto, Schweitzer, & Levine, 2014).…”

Section: Discussionmentioning

confidence: 99%

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Truong

Krawczyk

Dejman

et al. 2019

Addictive Behaviors

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Objective: This qualitative study identifies and describes experiences and challenges to retention of individuals with opioid use disorder (OUD) who participated in a low-threshold combined buprenorphine-peer support treatment program in Baltimore. Methods: In-depth semi-structured interviews with staff and former clients of the Project Connections Buprenorphine Program (PCBP) (9 people) and focus group discussions with current and previous clients of PCBP (7 people) were conducted. Content analysis was used to extract themes regarding barriers to enrolling and remaining in, and transitioning from the program. Results: Primary challenges identified by the participants included struggles with cravings and symptoms of withdrawal, comorbid mental health issues, criminal justice system involvement, medication stigma, and conflicts over level of flexibility regarding program requirements and the role of employment. Conclusions: This study identified several obstacles clients face when seeking care through a combined bupre- norphine-peer support model. Findings highlight potential programmatic factors that can be improved and additional resources that may support treatment retention rates and better outcomes. Despite challenges, low- threshold and community-based programs can increase access to effective maintenance treatment for OUD, especially among vulnerable populations who may not have access to formal health services.

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Section: Discussionmentioning

confidence: 99%

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Truong

Krawczyk

Dejman

et al. 2019

Addictive Behaviors

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show abstract

“…Participant learners include physicians of all specialties and nonphysician providers. Collegial discussions of clinical cases allow for shared interdisciplinary case-based learning (81).…”

Section: Telepsychiatry and New Technologies: Providing Care Despite The Mental Health Workforce Shortagementioning

confidence: 99%

Challenges and Opportunities to Meet the Mental Health Needs of Underserved and Disenfranchised Populations in the United States

Mongelli

Georgakopoulos

Pato³

2020

FOC

118

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This article investigates the gap in access to and quality of mental health care in the United States. This work first discusses how minority populations are most affected by the treatment gap. It summarizes recent literature on the topic for better understanding the needs of psychiatrically underserved and disenfranchised populations and the causes of mental health disparities. It reviews some of the barriers to behavioral health care, including lack of insurance coverage, lack of community-based interventions, unequal access to evidence-based practices, stigma, mental health workforce shortages, and geographical maldistribution of providers. Second, it reviews opportunities to address these disparities. The article provides examples of effective interventions that researchers worldwide have already implemented to address the gap of mental health services within the collaborative care model and global mental health initiatives. Telepsychiatry and improvements in training of the mental health workforce are also listed as useful implementations to overcome the treatment gap for patients seeking mental health care.

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“…Telementoring is a concept within digital health that involves the use of videoconferencing technology to provide real-time guidance and support between two or more clinicians in different geographic locations. Project ECHO is a method of telementoring that was started at the University of New Mexico for hepatitis C care in the early 2000s to disseminate information from academic medical centers to community-based clinicians (Arora et al, 2011; Hager et al, 2018). At UR, the Project ECHO paradigm is used to deliver geriatric and general psychiatry services.…”

Section: Ur’s Digital Behavioral Health Care Modelmentioning

confidence: 99%

The Digital Revolution in Behavioral Health

Hasselberg

2019

J Am Psychiatr Nurses Assoc

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BACKGROUND: Technology is disrupting every modern industry, from supermarkets to car manufacturing, and is now entering the health care space. Technological innovations in psychiatry include the opportunity for conducting therapy via two-way video conferencing, providing electronic consultations, and telementoring and education of community health care providers. Use of mobile health applications is also an expanding area of interest and promise. OBJECTIVE: The purpose of this article is to review the evolution and pros and cons of technology-enabled health care since the digital movement in psychiatry began more than 50 years ago as well as describe the University of Rochester’s innovative digital behavioral health care model. METHODS: A review of the literature and recent reports on innovations in digital behavioral health care was conducted, along with a review of the University of Rochester’s model to describe the current state of digital behavioral health care. RESULTS: Given the lack of access to care and mental health professional shortages in many parts of the United States, particularly rural areas, digital behavioral health care will be an increasingly important strategy for managing mental health care needs. However, there are numerous hurdles to be overcome in adopting digital health care, including provider resistance and knowledge gaps, lack of reimbursement parity, restrictive credentialing and privileging, and overregulation at both the state and federal levels. CONCLUSIONS: Digital health innovations are transforming the delivery of mental health care services and psychiatric mental health nurses can be on the forefront of this important digital revolution.

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Leveraging Behavioral Health Expertise: Practices and Potential of the Project ECHO Approach to Virtually Integrating Care in Underserved Areas

Cited by 35 publications

References 10 publications

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

Challenges and Opportunities to Meet the Mental Health Needs of Underserved and Disenfranchised Populations in the United States

The Digital Revolution in Behavioral Health

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