Behavioral Health Integration


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The provision of mental/behavioral health services for children and adolescents in the primary care setting is a volatile issue. This is one of several findings from an educational needs assessment of rural primary care providers focused on kid/teen mental/behavioral health. The session will briefly examine the high costs to families and the Commonwealth due to limited access to mental/behavioral health care as well as:

The process and scope of the educational needs assessment

Assessment outcomes—what providers see as their learning/educational needs

Strategies with potential to meet provider educational needs.

This program is a result of a Virginia Department of Health RFP which allowed four Area Health Education Centers to focus on provider learning needs. Session attendees will be encouraged to participate and contribute their ideas during the session.

Published in: Health & Medicine, Education
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Behavioral Health Integration

  1. 1. A Study of PCPs Educational Needs Relative to Child/Adolescent Behavioral Health within Selected Regions in the Commonwealth of Virginia 12/14/09 VDH-AHEC Collaborative Project
  2. 2. AHEC’s Involvement <ul><li>Who we are </li></ul><ul><li>How this effort </li></ul><ul><li>came about </li></ul><ul><li>The partners </li></ul>12/14/09 VDH-AHEC Collaborative Project
  3. 3. Participating AHECs 12/14/09 VDH-AHEC Collaborative Project
  4. 4. “ Jack’s” story <ul><li>“ Jack” was a cute little boy having a hard time in first grade </li></ul><ul><li>He had been tested, should have been an academic star </li></ul><ul><li>What’s happening? </li></ul>12/14/09 VDH-AHEC Collaborative Project
  5. 5. The Need <ul><li>92,000-111,000 Virginia children and adolescents have a serious emotional disturbance </li></ul><ul><li>Only 1 in 5 receives needed treatment </li></ul><ul><li>The average wait at community services boards to see a child psychiatrist was 31 days </li></ul>12/14/09 VDH-AHEC Collaborative Project
  6. 6. <ul><li>Department of Juvenile Justice reports that between 40-50% of incarcerated juvenile offenders have mental/behavioral health issues </li></ul><ul><li>Children who receive services as soon as they begin to show symptoms are less likely to escalate to the point of crisis (Cho) </li></ul>12/14/09 VDH-AHEC Collaborative Project
  7. 7. Some Study “Topics” <ul><li>Anxiety </li></ul><ul><li>Depression </li></ul><ul><li>Autism </li></ul><ul><li>ADHD </li></ul><ul><li>Behavioral Disorders (Conduct, Oppositional) </li></ul><ul><li>Bipolar </li></ul>12/14/09 VDH-AHEC Collaborative Project
  8. 8. More topics <ul><li>Eating Disorders </li></ul><ul><li>Learning Disabilities/Differences </li></ul><ul><li>Substance Abuse </li></ul>12/14/09 VDH-AHEC Collaborative Project
  9. 9. Integrated Care <ul><li>Spectrum looks like this: </li></ul><ul><li>Primary care and mental/behavioral health care providers </li></ul><ul><li>No interaction Collaboration Integration </li></ul>12/14/09 VDH-AHEC Collaborative Project
  10. 10. What are mental/behavioral health needs in your region? <ul><li>Related but not limited to children and adolescents </li></ul><ul><li>Adequate education, training of providers? </li></ul><ul><li>Sufficient time for comprehensive assessments? </li></ul><ul><li>Plenty of referral sources? </li></ul><ul><li>PCPs stay up-to-date about what’s happening with clients? </li></ul>12/14/09 VDH-AHEC Collaborative Project
  11. 11. What do you think about primary behavioral health care as part of medical services? 12/14/09 VDH-AHEC Collaborative Project
  12. 12. Study Objectives/Methods <ul><li>Develop and test study survey instruments </li></ul><ul><li>Implement the study </li></ul><ul><li>Analyze the data </li></ul><ul><li>Report the results </li></ul>12/14/09 VDH-AHEC Collaborative Project
  13. 13. Brief Summary of Findings <ul><li>80 primary care providers responded—mostly physicians </li></ul><ul><li>80% participated in at least one pediatric BH/MH-related training in the past year </li></ul><ul><li>95% expressed interest in training on pediatric mental health topics </li></ul><ul><li>84% needed at least some education on how to practice more collaboratively with child psychiatrists </li></ul><ul><li>Most preferred training format is in-person conferences, article review, video CE/CME, online CE/CME </li></ul>12/14/09 VDH-AHEC Collaborative Project
  14. 14. A Specific Finding <ul><li>CHCs having behavioral health providers indicated lesser BH/MH educational needs </li></ul><ul><li>Southside example </li></ul>12/14/09 VDH-AHEC Collaborative Project
  15. 15. Now…for those who must have charts, graphs, tables… <ul><li>Here are a few! </li></ul>12/14/09 VDH-AHEC Collaborative Project
  16. 16. 12/14/09 VDH-AHEC Collaborative Project
  17. 17. 12/14/09 VDH-AHEC Collaborative Project
  18. 18. 12/14/09 VDH-AHEC Collaborative Project
  19. 19. 12/14/09 VDH-AHEC Collaborative Project
  20. 20. Lessons Learned <ul><li>PCPs trying to keep abreast </li></ul><ul><li>Insufficient Resources (#Providers—primary care and mental health, Time, $$s) </li></ul><ul><li>Rising Need for MH/BH Care </li></ul><ul><li>Increasing Demands on PCPs </li></ul>12/14/09 VDH-AHEC Collaborative Project
  21. 21. Recommendations <ul><li>AHEC does not have the resources to make a quick and meaningful impact </li></ul><ul><li>We may be able to assist with the effort through a series of “baby steps” </li></ul>12/14/09 VDH-AHEC Collaborative Project