The document discusses behavioral health integration and its benefits. It defines behavioral health integration as the systematic coordination of mental health, substance abuse, and primary care services through a team approach using evidence-based practices. Integrating behavioral health services into primary care settings provides a one-stop shop for patients, benefits patients and providers by improving quality of care, and lowers overall healthcare costs by 20-40%. The document recommends integrating behavioral health practitioners into primary care clinics to assist patients with lifestyle changes, medication compliance, and management of chronic conditions, mental health issues, and substance abuse.
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
Webinar broadcast on Feb 27, 2019 - 3:00PM EST
Delivering behavioral health services as a part of an integrated team is crucial to providing comprehensive primary care services. Focusing on the vital role of behavioral health, experts will share the key elements that maximize the contributions of these team members through structured approaches to screening, the use of “warm hand offs” to ensure connection to primary care, and implementing a robust group of treatment programs to enhance access and improve outcomes. This session will also discuss the day-to-day operation of a behavioral health program and detail the data and clinical dashboard that supports the work of these vital team members. There has been tremendous progress from health centers across the country in the integrating behavioral health, this webinar will share how integrated behavioral health can advance the team’s capability to provide effective and high quality care to complex patient populations.
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
Webinar broadcast on Feb 27, 2019 - 3:00PM EST
Delivering behavioral health services as a part of an integrated team is crucial to providing comprehensive primary care services. Focusing on the vital role of behavioral health, experts will share the key elements that maximize the contributions of these team members through structured approaches to screening, the use of “warm hand offs” to ensure connection to primary care, and implementing a robust group of treatment programs to enhance access and improve outcomes. This session will also discuss the day-to-day operation of a behavioral health program and detail the data and clinical dashboard that supports the work of these vital team members. There has been tremendous progress from health centers across the country in the integrating behavioral health, this webinar will share how integrated behavioral health can advance the team’s capability to provide effective and high quality care to complex patient populations.
Health promotion is, as stated in the 1986 World Health Organization Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health
Palliative Care Interdisciplinary Team model for Clinical Ethics Consultation...Andi Chatburn, DO, MA
Interactive workshop presentation exploring the Palliative Care model for Interdisciplinary Team consultation in an application for Clinical Ethics Consultation. Presented at the American Society for Bioethics and Humanities national conference in San Diego, October 17, 2014.
A personalized training workshop for the PRM Department Staff at KSUMC at large. The specific target audience is the CPG working groups and new committee members.
Code of ethics and legal practices has been very old element in the professional management of the doctor’s behaviour. The ethical practices or code shows a commitment to act with honesty in extreme situations. At the time patients seek medical treatment they are not just entering a normal social relationship, they often feel vulnerable but required to share and expose important aspects of their lives. Codes of ethical conducts provide some tangible safety to both doctors and patients in such circumstances. In the below report, the researcher is explaining ethical, legal and
professional guidelines and principles for health care as well as its implications in the healthcare sector of the United Kingdom. After reading this report, the reader would be able to understand how healthcare adopts ethical practices at the workplace and ensures protection of patients in their medical treatment.
Module 6, Role and functions of medical social work in various medical settings.
Unit 21 - PATIENT AND FAMILY EDUCATION
(Social Work in the field of health- MSW (S3))
During challenging times, it can really help to have sufficient personal time with a compassionate, knowledgeable physician who is experienced in family medicine and has specialized training in counseling — who listens to you, and offers caring support and expert guidance.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Attendees will gain insight into the stigma that is attached to individuals who have dual diagnosis and criminal justice involvement, as well as, the importance of instilling power and hope to the individual. They will increase knowledge of the stages of change and utilizing motivational interviewing techniques to assist the individual through their path of recovery from mental illness, substance abuse, and criminal justice involvement.
Palliative Care Interdisciplinary Team model for Clinical Ethics Consultation...Andi Chatburn, DO, MA
Interactive workshop presentation exploring the Palliative Care model for Interdisciplinary Team consultation in an application for Clinical Ethics Consultation. Presented at the American Society for Bioethics and Humanities national conference in San Diego, October 17, 2014.
A personalized training workshop for the PRM Department Staff at KSUMC at large. The specific target audience is the CPG working groups and new committee members.
Code of ethics and legal practices has been very old element in the professional management of the doctor’s behaviour. The ethical practices or code shows a commitment to act with honesty in extreme situations. At the time patients seek medical treatment they are not just entering a normal social relationship, they often feel vulnerable but required to share and expose important aspects of their lives. Codes of ethical conducts provide some tangible safety to both doctors and patients in such circumstances. In the below report, the researcher is explaining ethical, legal and
professional guidelines and principles for health care as well as its implications in the healthcare sector of the United Kingdom. After reading this report, the reader would be able to understand how healthcare adopts ethical practices at the workplace and ensures protection of patients in their medical treatment.
Module 6, Role and functions of medical social work in various medical settings.
Unit 21 - PATIENT AND FAMILY EDUCATION
(Social Work in the field of health- MSW (S3))
During challenging times, it can really help to have sufficient personal time with a compassionate, knowledgeable physician who is experienced in family medicine and has specialized training in counseling — who listens to you, and offers caring support and expert guidance.
This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.
Attendees will gain insight into the stigma that is attached to individuals who have dual diagnosis and criminal justice involvement, as well as, the importance of instilling power and hope to the individual. They will increase knowledge of the stages of change and utilizing motivational interviewing techniques to assist the individual through their path of recovery from mental illness, substance abuse, and criminal justice involvement.
Review best practices for working with persons with addictions and mental health issues. NBCC, NAADAC, CAADAC, and California Board of Behavioral Sciences approved Mental Health continuing education and addictions counselor training series. Narrated versions and CEUs available at http://www.allceus.com
Douglas Ziedonis M.D. -
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry
Department of Psychiatry, University of Massachusetts Medical School & UMass Memorial Health Care
Dr. Ziedonis addresses the RiverMend Health Scientific Advisory Board on co-occurring addictions and processes to help treat them.
To watch lecture visit :http://vimeo.com/100314352
For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
Training innovations dual diagnosis cambian fountains march 16Patrick Doyle
Dual Diagnosis describes the co-occurring problems of mental illness and substance misuse. However, the term 'dual' is something of a misnomer - the needs of this client group are often highly complex and extend beyond the relatively simplistic scenario implied by the term 'dual diagnosis'. This course uses realistic scenarios to enable participants to look at the reasons why mentally ill clients are so prone to drug and alcohol problems, the potential consequences of dual diagnosis, and current assessment and treatment approaches
Duration: half-day. one day, or two day options
Experience: None required
This course is suitable for: all staff currently working within health and social care settings in the United Kingdom. The course is designed to meet the training needs of domiciliary care agencies, care home or hospital settings and all staff. The course is also ideal for carers.
Number of Trainees: 15 maximum
Course Standard: Certificate of attendance
Equipment Needed: Hand-outs will be provided
Candidates will cover:
•Definitions of dual diagnosis and co-morbidity.
•Possible reasons for substance misuse in those with mental health difficulties
•Effects of substance misuse on those with mental health difficulties
By the end of the course Candidates will be able to:
•Discuss the relationship between substance misuse and mental health problems
•Describe the risk factors associated with these behaviours
•Understand the skills that are necessary to effectively work with clients who have dual diagnosis
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Unlimited Counseling CEUs for $59 https://www.allceus.com/
Specialty Certificate tracks starting at $89 https://www.allceus.com/certificate-tracks/
Live Webinars $5/hour https://www.allceus.com/live-interactive-webinars/
Patreon: https://www.patreon.com/CounselorToolbox
Pinterest: drsnipes
People with addictions and those who commit crimes have self-esteem issues in addition to a characteristic set of cognitive distortions. Learn what those are and how to help your client address them.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
Help patients achieve lasting recovery by addressing ALL causes of their symptoms.
Unlimited Counseling CEUs for $59 https://www.allceus.com/
Specialty Certificate tracks starting at $89 https://www.allceus.com/certificate-tracks/
Live Webinars $5/hour https://www.allceus.com/live-interactive-webinars/
CEs can be earned for this presentation at: https://www.allceus.com/member/cart/index/product/id/503/c/
Pinterest: drsnipes
Counselor Toolbox Podcast: Https://allceus.com/counselortoolbox
Youtube: https://www.youtube.com/user/allceuseducation
Nurses, addiction and mental health counselors, social workers and marriage and family therapists can earn continuing education credits (CEs) for this and other course at:
View the New Harbinger Catalog and get your 25% discount on their products by entering coupon code: 1168SNIPES at check out
AllCEUs has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6261. Programs that do not qualify for NBCC Credit are clearly identified. AllCEUs is solely responsible for all aspects of the programs.
AllCEUs is also approved as an education provider for NAADAC, the States of Florida and Texas Boards of Social Work and Mental Health/Professional Counseling, the California Consortium for Addiction Professionals and Professions. Our courses are accepted in most states through those approvals.
Recovery from Addictions in Healthcare workers - by Ann Sparks (research synt...Ann Hinnen Sparks
Research Proposal of Experiential responses for various levels of health care workers who are in active recovery from addictions to mood altering substances.
Lesson 10 Integrated mental healthhealthcare and future of menta.docxSHIVA101531
Lesson 10: Integrated /mental health/healthcare and future of mental health services in public sector
Readings:
Schuffman, D., Druss, B.G., & Parks, J.J. (2009). Mending Missouri’s safety net: Transforming systems of care by integrating primary and behavioral health care. Psychiatric Services, 60(5), 585-588.
Hogan MF, Sederer LI, Smith TE, & Nossel IR. (2010). Making room for mental health in the medical home. Prev. Chronic Dis. 7(6):A132 [Erratum appears in Prev Chronic Dis 2010;8(1). http://www.cdc.gov/pcd/issues/2011/jan/10_0249.htm.]
Mechanic, D. (2012). Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system. Health Affairs, 31(2), 376-382. http://content.healthaffairs.org/content/31/2/376.short
View the short video on the Health Resources and Services Administration (HRSA) website about a primary care program in Tennessee. Available at: http://www.hrsa.gov/publichealth/clinical/BehavioralHealth/
Introduction
Goal 1 of the President’s New Freedom Commission Report states that: “Americans understand that mental health is essential to overall health.” This seems like a simple enough goal. It is, however, not as easy to achieve as it appears.
The link between mental and physical health has long been a subject of interest to theorists and practitioners and has been studied in the general population. For example, in a general population study, Sederer et al. (2006) found that those New Yorkers who reported nonspecific psychological distress suffered more physical health problems, were more likely to smoke, be inactive and have a poor diet than those who didn’t report distress. They noted that these individuals were much more likely to have hypertension, hyperlipidemia, obesity, asthma, and diabetes.
The link with physical health is especially important for those suffering from serious mental illness. We learned in a previous lesson that persons with serious mental illness were likely to die 25 years earlier than adults in the general population (Colton & Manderscheid, 2006). Of those who die, 87% do so because of medical illnesses (Parks, Radke, & Mazade, 2008). These studies, results from Sederer et al. in a general population, and others show that physical and psychological problems not only co-exist, but also have a relationship. Treating one without addressing the other will result in inadequate care for the individual who suffers from both. Not much in terms of practice, however, has been done to address this issue until fairly recently.
Why Integrate Care?
Addressing the physical health needs of persons with mental illness has become increasingly important as more evidence becomes available of the link between them. An account of a recently held forum at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care noted:
“For years, the prevailing notion in medicine held that the body is treated in a physician's office and the mind in a ...
Responsed to colleagues posting that addressed different trends tha.docxzmark3
Responsed to colleague's posting that addressed different trends than those you described. Agree or disagree with the colleague's position on the current and future trends in the treatment of addiction.
Colleague #1
Current trends:
There are a number of trends within the addiction recovery and treatment field. One of the most utilized modalities within the field of addiction recovery may be cognitive behavioral therapy (CBT). CBT seeks to teach those recovering from addiction and other mental illness to find connections between their thoughts, feelings and even their actions or behaviors (Kiluk & Carroll, 2013). The cognitive behavioral approach often encourages those participating in the treatment to identify, and challenge potential thinking errors that may be contributing to their current addiction, or even mental illness.
Another widely used treatment trend is the 12-step program. This program is one that is based on peer support groups that meet together regularly to provide support, guidance and care as each individual works the program as a whole (AAWS, 2012). The basic assumption of the intervention model is that people can help one another achieve and maintain abstinence from substances, and healing cannot come about until one surrenders to a higher power (AAWS, 2012). This is a widely spread program that is estimated to be used by the majority of treatment centers throughout the country (Doweiko, 2019).
Future trends:
There have been a number of developments and shifts within the field of addiction recovery therapy. It seems that societal trends, to a certain extent, may have some sort of impact on the trends as they develop as well. For example, there has been more of an emphasis placed on holistic health, and holistic treatment in a number of fields. This trend may be seen being implemented into the field of substance abuse treatment, and recovery as well.
Drake (2020) suggests that holistic care should be integrated into a multidisciplinary approach within the substance abuse field. The concept of incorporating a registered dietician to the multidisciplinary approach supports the “moniker” of providing a holistic approach to those in substance abuse disorder treatment. Implementing this style of holistic care is said to improve the overall quality of treatment and recovery. It has been reported that those with substance use disorders have become well quicker, fewer symptoms, and sustain recovery longer when they follow principles of quality nutrition (Drake, 2020).
Similarly, there have been various studies implementing the Integrative Body Mind Spirit (I-BMS) intervention among those with substance use disorders. This intervention utilizes Western practices in congruence with Eastern philosophies, as well as techniques (Rentala et al., 2020) There are a number of specific interventions utilized within this particular program that all seek to foster a deeper connection between body, mind and spirit. One of the most com.
Running head Identification of Complementary and Alternative Medi.docxcharisellington63520
Running head: Identification of Complementary and Alternative Medicine 1
INTREGRETING HOMEOPATHIC TREATMENT WITH CARE OF CANCER 7
Integrating Homeopathic Treatment with the Care of Cancer
Teresa Campbell
HCS: 321 Foundations of Complementary and Alternative Medicine
Belinda Atchison
August 20, 2015
While In contrast, is their really enough antidotal evidence that suggest complementary and alternative medicine is more effective then mainstream medicine in the treatment of cancer? There is supported evidence that when remedies are properly used in homeopathic care, specific remedies have reversed the growth of cancer. Various forms of homeopathic therapy allow the patient to take control of their health while making small manageable changes without the huge cost. Alternative therapies open new options for patients without harmful side-effects. The interest in preventative health has encouraged society to explore outside of the mainstream field of medicine and the options of various therapies are now being considered. Is it possible for Homeopathic remedies to be the future treatment and care for cancer?
Complementary and Alternative Medicine (CAM)
Protocols
Treating the person and as a whole being (Mind, body and spirit).
The focus on engaging the inner resources of each individual as an active & conscious participate in their own well-being. Complementary and Alternative systems do not research into echelons the practitioner/healer is not above the one that is being healed. The relationship is on a continuum of mutuality where both walk step-by-step on the journey to healing (Koopsen and Young, 2009).
Historical events
Samuel Hahnemann noted the description of a remedy made from "Peruvian Tree Bark" (Cinchona) (Cuellar, 2006. p. 79). Hahnemann’s “The Organon of Medicine” was published from first edition in eighteen ten, and “The Organon of the Healing Art” in nineteen twenty-one which enhanced the influence of homeopathic theory significantly. (Micozzi, M, 2015)
Chronic Disease
Chronic illnesses refer to those illnesses that are usually not fully recovered from them once a person has them. (Burkholder, Nash, 2014). Chronic conditions can remain for life, it is important for those affected by them to understand their condition and related care in order to achieve the highest quality of life. (Eliopoulos, 2014, p.280, para 1)
CAM perspective
The law of Similars, Allow the body to heal itself (Micozzi, 2015, p.385 para, 6). Cam perspective is to define what is causing disharmony in the body, treat it, and then allow the body to heal itself. We live in an era when individuals can survive and have a high quality life being empowered with knowledge, having a support system, and having a positive mind frame. The healing approach is stimulated by information.
Cultural Challenges
Culture includes spirituality and religious practices, which are intimately related to health beliefs and practices, an.
Team approach in mental health service delivery, multi-disciplinary team, psy...Celente French
Differentiate between the roles of the team members in a multi-professional mental health team.
Evaluate the legal provision for each team member’s scope of practice.
Evaluate the contribution of the multi-professional team to the facilitation of the community’s mental health.
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
Running head PSYCHOTHERAPY APPROACHES .docxtodd581
Running head: PSYCHOTHERAPY APPROACHES 1
PSYCHOTHERAPY APPROACHES 2
Supportive and interpersonal psychotherapy approaches
Name
Institutions
Supportive and interpersonal psychotherapy approaches
With the prevalence of mental disorders, researchers and healthcare providers have studied the efficacy of different psychotherapy approaches to determine the most efficient strategies that can be used in assisting patients with particular psychiatric disorders. Supportive psychotherapy along with interpersonal psychotherapy are prevalently used in the treatment of mental disorders. These two approaches have various similarities as well as differences. Herein, I will discuss the two psychotherapy approaches, their similarities, differences, and situations in which each of the approaches would be effective in the treatment of patients with psychiatric disorders.
Similarities and Differences of Supportive and Interpersonal Psychotherapy Approaches
Supportive psychotherapy approach refers to a form of psychotherapeutic strategy that combines psychodynamic, cognitive-behavioral as well as interpersonal conceptual approaches of psychotherapy and techniques (Wheeler, 2014). With this psychotherapy approach, the major aim of the therapist is to improve the adaptive along with healthy patterns of the patient with the major objective being to reduce the prevailing intrapsychic conflicts contributing to the patient’s condition. On the other hand, the interpersonal approach refers to a brief, interpersonal focused strategy, which concentrates on identifying and resolving the prevailing interpersonal problems to alleviate the presenting symptoms (Wheeler, 2014). The therapist is essentially concerned with the interpersonal context and the associated factors that may predispose, propagate or precipitate the symptom of psychiatric disorders.
Both approaches are mainly aimed at bringing a therapeutic impact to patients presenting with the symptoms of psychiatric conditions. However, the two approaches have differences. Firstly, the interpersonal approach is an emphatically supported treatment model that mainly adheres to a highly structured and time-limited approach that often takes between 12 to 16 weeks (Cuijpers et al., 2016). Conversely, the supportive approach is not structured and utilizes a combination or either the psychodynamic, cognitive-behavioral and/or interpersonal conceptual approach. What is more, as highlighted in the above paragraph, the main aim of the supportive approach is to enhance the patient’s healthy as well as adaptive patterns in order lessen the prevailing intrapsychic conflicts contributing to the development of mental disorders. Conversely, the main aim of using the interpersonal approach is to ide.
Barriers to Practice and Impact on CareAn Analysis of the P.docxrosemaryralphs52525
Barriers to Practice and Impact on Care:
An Analysis of the Psychiatric Mental
Health Nurse Practitioner Role
Heather Muxworthy, DNR PMHNP-BC
Nancy Bowllan, EdD, MS, RN
• Abstract
This paper is a retrospective review of the literature analyzing the role of the psychiatric mental health nurse practitioner in
the community. Presented here is an appraisal of national and state mental health initiatives. Professional nursing regulations
are reviewed, focusing on New >brk State advanced practice nursing. Barriers to practice are assessed with discussion on how
barriers, such as statutory collaboration, impede access to treatment in the community for mentally ill psychiatric patients.
The current New )brk State legislative agenda is featured. Clinical vignettes from a nurse practitioner's private community
practice are presented to introduce and conclude how clinical practice barriers impede autonomous practice.
Clinical vignette (2007)
An advanced practice psychiatric mental
health nurse practitioner (APRN-PMHNP)
provides mental health services within a
small community based private practice. The
New York State Nurse Practice Tlci mandates
that a psychiatric nurse practitioner (NP)
maintain a statutory collaborative agreement
with a collaborating psychiatrist in order
to provide comprehensive mental health
services. Although some third-party insurance
companies authorize APRN-PMHNPs on
panels, a collaborative agreement must be
established with a psychiatrist from each
insurance panel. This becomes a critical issue
when the collaborative psychiatrist decided to
close his practice and abruptly discontinued
the collaborative agreement. In order to prevent
discontinuity in care, the APRN-PMHNP needed
to establish a collaborative agreement with
another psychiatrist and develop a practice
agreement (Form 4NP) based on protocols
established by the State of New York. This
time-consuming process resulted in a disruption
in treatment for several patients. The APRN-
PMHNP managing this case reported a major
incident by a high-risk patient that occurred
as a result of this disruption in continuity of
care. This case vignette highlights the potential
negative consequences related to statutory
collaborative agreements as well as the ability
of an APRN-PMHNP to provide effective, safe,
and consistent care.
Introduction
Several national initiatives in the past
decade have identified mental healthcare
indicators that address system issues and the
efficiency of access to mental health treatment
by consumers within the community. Healthy
People 2010, Healthy People 2020, and the
National Consensus Statement on Mental
Health Recovery are o n l y a few of the
national initiatives that recognize the lack
of access and need for more mental health
Heather Muxworthy is a psychiatric/mental health r^urse practitioner at Wegman s School of Nursing. St. ¡ohn Fisher College in Rochester. NY. Nancy Bowllan
is a clinical nurse specialist track coordinator and associate.
2. What is behavioral health integration?
It is a systematic coordination of integrating mental health,
substance abuse, and primary care services through a team
approach, utilizing evidence based practices.
Research has proven this integration to be the most effective
approach towards achieving a greater efficacy for people
with multiple healthcare needs.
(SAMHSA-HRSA, 2012)
Behavioral Health Integration
2
Presented by Terry L. Dunlop, D. BH
3. For doctors and other health care professionals, integrated care will
provide resources to monitor all health conditions a person may have and
to coordinate treatments so they don’t interfere with each other.
SAMHSA-HRSA Center for Integrated Health. (2012).
A research survey was conducted by Spectrum Health, Inc. in Bellevue,
WA with the Seattle area primary care physicians. The results were:
71% of office visits were for follow-up to chronic conditions.
Over 70% stated the preferred mode of treating chronic pain would
include lifestyle management.
Over 70% stated the preferred mode of treatment for asthma would
include lifestyle management.
(American Medical Association, 1999, Mauer, 2003)
3
How will integrating behavioral health benefit
patients, physicians, & the medical community?
Presented by Terry L. Dunlop, D. BH
4. How will integrating behavioral health benefit
patients, physicians, & the medical community?
Cont.
Almost 90% stated preferred mode for treating diabetes would include
lifestyle management.
Well over 80% stated the preferred mode for treating hypertension would
include lifestyle management.
Less than 30% of the time in all follow-up visits were patients suffering
these disorders seen by anyone other than a physician.
People with chronic conditions as well as many of those with behavioral
problems often need to make lifestyle changes that a structured
psychoeducational program can facilitate. (Mauer, 2003)
One provider can bill and treat multiple patients at the same time.
(Dyer, Levy, & Dyer, 2005, pp. 71-86)
4
Presented by Terry L. Dunlop, D. BH
5. The Benefits of Integrated Behavioral Health
1. Integrating Behavioral Health Care providers into existing
medical facilities provides a “1 stop shop” for medical/mental
health services for patients.
2. Integrated health care benefits patients, caregivers, and providers
by augmenting services, improve quality of care, and lower
overall health care expenditures.
3. Integrated behavioral health care is less costly. (Typical savings
range between 20 and 40%, called the “medical cost offset.”)
4. Patients with behavioral problems or mood disorders such as
sleep disorders, depression, or anxiety can benefit from short
behavioral interventions from the BCP.
5
(Dyer, Levy, & Dyer, 2005, pp. 71-86)
(Tovian, 2009; Hunter, Goodie, Oordt, & Dobmeyer, 2009)
Presented by Terry L. Dunlop, D. BH
6. How behavioral health interventions assist in
the management of disease.
30 years of research suggests medical non-compliance rates with
prescriptions exceed 50% across many diverse syndromes for diet
and activity prescriptions.
60% non-compliance with antidepressant medication within six
months of initial prescription.
Patients with chronic conditions are difficult to present a lifestyle
change in the typical 12-minute primary care physician (PCP)-
patient interaction. A BCP will work with patients creating
treatment goals that include lifestyle changes, such as in diet,
smoking cessation, medication compliance, diabetes monitoring
and implementing exercise regimens attending sessions with BCP.
(Dyer, Levy, & Dyer, 2005, pp. 71-86)
6
(Katon, et.al., 1992).
Presented by Terry L. Dunlop, D. BH
7. How behavioral health interventions assist in
the management of substance abuse.
7
Group treatment has been found to be superior to individual
treatment for substance abuse, when treatment lasted for ten or
fewer total sessions
(McRoberts, Burlingame, & Hoag, 1998).
This will improve patient care and outcomes, and also ease the
burden for the PCP. (Dyer, Levy, & Dyer, 2005, pp. 71-86)
Integrated treatment produces better outcomes for individuals
with co-occurring mental and substance use disorders. By
providing the clinical services , the PCP and BCP will be able to
meet the individual's substance abuse, mental health, and other
needs. (SAMSHA, 2012)
Presented by Terry L. Dunlop, D. BH
8. How behavioral health interventions assist in
the management of mental health disorders.
Individuals with serious mental illness have a 25 year shorter
lifespan with the primary cause of death being cardiovascular
disease.
Integrated health care for mental health disorders will augment
services by improving the quality of care at one location, monitor
medications regularly and again lower overall health care
expenditures.
This will improve patient care and outcomes, and also ease the
burden for the PCP.
8
National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council. (2006).
Presented by Terry L. Dunlop, D. BH
9. How to integrate behavioral health into an
existing clinic or hospital setting.
1. One way to better serve these patients is to integrate a behavioral
health practitioner down the hall from the PCP; into the primary
care practice.
2. Offer psychoeducation for groups. (Literature supports improved
clinical outcomes from group health encounters and group
encounters are billed with same E&M codes as individual
encounters.)
9
Presented by Terry L. Dunlop, D. BH
10. Behavioral Health Integration Final Comments
Marc Braman, American College of Lifestyle Medicine (ACLM) Past
President notes: “With this new kind of professional that is so skilled
with the heart of Lifestyle Medicine entering the healthcare arena, it will
be exciting to see how they become an important part of Lifestyle
Medicine specialty practice.”
The Air Force has had a large integration project under way for several
years that follows a behavioral health consultant model (referral) using
clinical psychologists and social workers (Oordt, 2004).
The SAMHSA Prime-E Study (Primary Care Research in Substance Abuse
and Mental Health for the Elderly) Preliminary results:
1. Increased engagement by 72% in the collocated services vs. 48% for
specialty care.
2. Alcohol related abuse, 72% vs. 29%, respectively
(Quijano, 2004).
10
Presented by Terry L. Dunlop, D. BH
11. References
American Medical Association. (1999). Social and demographic characteristics of Physicians
in America. Washington, D.C.: AMA.
Cummings, N., Cummings, J, & Johnson, J. (1997). Behavioral health in primary care: A
guide to clinical integration. Madison, CN: Psychosocial Press.
Dyer, J. R., Levy, R., & Dyer, R. L. (2005). An integrated model for changing patient
behavior in primary care. In N. Cummings, W. O'Donahue, & E. Naylor (Eds.),
Psychological approaches to chronic disease management (pp. 71-86). Reno, NV: Context
Press.
Hunter, C.L., Goodie, J.L., Oordt, M.S., & Dobmeyer, A.C. (2009). Integrated behavioral
health in primary care. Washington, D.C.: American Psychological Association.
Katon, W. (2001). A randomized trial of relapse prevention of depression in primary
care. General Psychiatry, 58, 241-247.
Katon, W. (1999). Stepped collaborative care for primary care patients with persistent
symptoms of depression. General Psychiatry, 56, 1109-1115.
Mauer, B. J. (2003). Behavioral health/primary care integration models, competencies,
and infrastructure [Special issue]. National Council for Community Behavioral
Healthcare.
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12. References
McRoberts, C., Burlingame, G. M., & Hoag, M. (1998). Comparative efficacy of
individual and group psychotherapy: A meta-analytic perspective. Group
Dynamics: Theory, Research, and Practice, 2, 101-117.
Oordt, M.S. (2004). Behavioral health optimization: An update on integrated primary
care in the Air Force medical system. Society of Behavioral Medicine, Baltimore.
O'Donohue, W.T., Cummings, N.A., Cucciare, M.A., Runyan, C.N., & Cummings, J.L.
(2006). Integrated behavioral health care: A guide to effective intervention. Amhurst,
N.Y.: Humanity Books.
Quijano, L.M. (2004). Preliminary results: PRIME-E study. National Council for
Community Behavioral Healthcare, New Orleans.
SAMHSA-HRSA Center for Integrated Health. (2012). What is integrated care. Retrieved
from http://www.integration.samhsa.gov/about-us/what-is-integrated-care.
SAMSHA. (2012). Integrating mental health and substance abuse treatment. Retrieved from
http://www.samhsa.gov/co-occurring/topics/healthcare-integration/index.aspx
Tovian, S. M. (2009). Five questions for Steven Tovian PhD. American Psychological
Association. Retrieved January 16, 2013 from
http://www.newswise.com/articles/five-questions-for-steven-tovian-phd.
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Editor's Notes
Substance Abuse and Mental Health Services Administration (SAMSHA) has developed the Primary and Behavioral Health Care Integration (PBHCI) Program. Through this program, SAMHSA provides support to communities to coordinate and integrate primary care services into publicly funded, community-based behavioral health settings.
What is Lifestyle Management? Providing psychoeducation to patients to self-manage their medical issues by being informed, compliant to medications, adherent to necessary lifestyle changes, and, most importantly, is an active partner in his or her care.
*Over 70% did not offer lifestyle management services in their practices.
Consider how much income was lost from these medical clinics by not having a BCP in house.
How? Solution: BCP offers brief sessions for patients utilizing psychoeducation for the self-management of their disease and reinforce healthy lifestyle habits. Also, group treatment has been found to be superior to individual treatment for chronic pain, substance abuse, weight control, parenting problems,
vocational problems, and when treatment lasted for ten or fewer total sessions. (McRoberts, Burlingame, & Hoag, 1998).
Imagine an in house BCP providing routine services with this population. A 30% increase in life spans would benefit the patient and the clinic.
Group billable codes at the medical settings increase revenue.