The Readiness for Integrated Care Questionnaire (RICQ): An instrument to assess readiness to integrate behavioral health and primary care.

2017 ◽  
Vol 87 (5) ◽  
pp. 520-530 ◽  
Author(s):  
Victoria C. Scott ◽  
Tara Kenworthy ◽  
Erin Godly-Reynolds ◽  
Gilberte Bastien ◽  
Jonathan Scaccia ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Integrated Care

Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

2018 ◽  
Vol 58 (2) ◽  
pp. 213-225 ◽  
Author(s):  
David J. Kolko ◽  
Eunice Torres ◽  
Kevin Rumbarger ◽  
Everette James ◽  
Renee Turchi ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Integrated Care ◽  
Primary Care Physicians ◽  
Empirical Literature ◽  
Health Providers ◽  
Pediatric Health ◽  
Care Experience ◽  
Pediatric Health Care

This study reports on a statewide survey of medical and behavioral health professionals to advance the knowledge base on the benefits and obstacles to delivering integrated pediatric health care. Surveys distributed in 3 statewide provider networks were completed by 110 behavioral health specialists (BHSs) and 111 primary care physicians (PCPs). Survey content documented their perceptions about key services, benefits, barriers, and needed opportunities related to integrated care. Factor analyses identified 8 factors, and other items were examined individually. We compared responses by specialty group (BHS vs PCP) and integrated care experience (no vs yes). The findings revealed differences across domains by specialty subgroup. In several cases, BHS (vs PCP) respondents, especially those with integrated care experience, reported lower benefits, higher barriers, and fewer resource requests. The implications of these results for enhancing care integration development, delivery, training, and research are discussed along with the study’s limitations and empirical literature.

Integrating Behavioral Health and Primary Care

2017 ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Integrated Care ◽  
Brief Treatment ◽  
Patient Centered ◽  
Care Environment ◽  
Treatment Approaches ◽  
Integrated Team

This book describes real-world examples and practical approaches for integrating behavioral and physical health services in primary care and some specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists who are working in ambulatory/office-based practices. We examine the integrated care literature and recommend applying collaborative care and other existing models of integrated care based on the existing evidence-based research. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems. We assume the use of a fully integrated team staffing model while also recognizing this an ideal that may need modification based on local resources and practice cultures. The full integrated team includes a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s). The book has four sections: Part 1: Models of Integrated Care provides an overview of the principles and the framework of integrated care focusing on five highly successful integrated practices. We also discuss team-based care, financing, tele-behavioral health, and use of mental health assessments and outcome measures. Part 2: Integrative Care for Psychiatry and Primary Care is a review of existing and proposed models of integrated care for common psychiatric disorders. Our continuity approach emphasizes problem identification, differential diagnosis, brief treatment, and yearlong critical pathways with tables and figures detailing “how to” effectively deliver mental health care and manage substance misuse in an integrated care environment. Part 3: Integrated Care for Medical Sub-Specialties & Behavioral Medicine Conditions in Primary Care focuses on two models of integrating behavioral health care: (1) integrating wellness with behavioral health and (2) integrating psychiatry and neurology. Other chapters are “Women’s Mental Health Across the Reproductive Lifespan,” “Assessing and Treating Sexual Problems in an Integrated Care Environment,” “Integrated Chronic Pain and Psychiatric Management,” and “Death and Dying: Integrated Teams.” Part 4: Psychosocial Treatments in Integrated Care describes brief office-based counseling and psychosocial treatment approaches including: health coaching, crisis intervention, family, and group interventions. All of these brief treatment approaches are patient–centered, tailored to be used effectively integrated care settings and as an important contribution to population management.

scholarly journals Strategic implementation planning for integrated behavioral health services in pediatric primary care

2021 ◽  
Vol 2 ◽  
pp. 263348952098755
Author(s):  
Jennifer A Mautone ◽  
Courtney Benjamin Wolk ◽  
Zuleyha Cidav ◽  
Molly F Davis ◽  
Jami F Young
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Behavioral Health ◽  
Integrated Care ◽  
Care Program ◽  
Logic Model ◽  
Pediatric Primary Care ◽  
Behavioral Health Services ◽  
Integrated Behavioral Health ◽  
Strategic Implementation

Background: Delivering physical and behavioral health services in a single setting is associated with improved quality of care and reduced health care costs. Few health systems implementing integrated care develop conceptual models and targeted measurement strategies a priori with an eye toward adoption, implementation, sustainment, and evaluation. This is a broad challenge in the field, which can make it difficult to disentangle why implementation is or is not successful. Method: This article discusses strategic implementation and evaluation planning for a pediatric integrated care program in a large health system. Our team developed a logic model, which defines resources and community characteristics, program components, evaluation activities, short-term activities, and intermediate and anticipated long-term patient-, clinician-, and practice-related outcomes. The model was designed based on research and stakeholder input to support strategic implementation and evaluation of the program. For each aspect of the logic model, a measurement battery was selected. Initial implementation data and intermediate outcomes from a pilot in five practices in a 30-practice pediatric primary care network are presented to illustrate how the logic model and evaluation plan have been used to guide the iterative process of program development. Results: A total of 4,619 office visits were completed during the 2 years of the pilot. Primary care clinicians were highly satisfied with the integrated primary care program and provided feedback on ways to further improve the program. Members of the primary care team and behavioral health providers rated the program as being relatively well integrated into the practices after the second year of the pilot. Conclusion: This logic model and evaluation plan provide a template for future projects integrating behavioral health services in non-specialty mental health settings, including pediatric primary care, and can be used broadly to provide structure to implementation and evaluation activities and promote replication of effective initiatives. Plain language abstract: Up to 1 in 5 youth have difficulties with mental health; however, the majority of these youth do not receive the care they need. Many youth seek support from their primary care clinicians. Pediatric primary care practices have increasingly integrated behavioral health clinicians into the care team to improve access to services and encourage high-quality team-based care. Definitions of “behavioral health integration” vary across disciplines and organizations, and little is known about how integrated behavioral health care is actually implemented in most pediatric settings. In addition, program evaluation activities have not included a thorough examination of long-term outcomes. This article provides detailed information on the implementation planning and evaluation activities for an integrated behavioral health program in pediatric primary care. This work has been guided by a logic model, an important implementation science tool to guide the development and evaluation of new programs and promote replication. The logic model and measurement plan we developed provides a guide for policy makers, researchers, and clinicians seeking to develop and evaluate similar programs in other systems and community settings. This work will enable greater adoption, implementation, and sustainment of integrated care models and increase access to high-quality care.

Integrated care effectiveness for adults with co-occurring disorders

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Angela Mooss ◽  
Joyce Myatt ◽  
Jennifer Goldman ◽  
Joey-Ann Alexander
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Behavioral Health ◽  
Integrated Care ◽  
Small Sample ◽  
Emergency Department Visits ◽  
Health Clinic ◽  
Content Type ◽  
Ed Visits ◽  
Multiple Morbidities

PurposeThis study examined effectiveness of an integrated care program on emergency department visits within a longitudinal sample of patients with both primary care and behavioral health diagnoses.Design/methodology/approachPatients with co-occurring disorders enrolled in an integrated care clinic and were followed over time to determine whether participation in the clinic, including engagement in wellness/peer services, predicted decreases in Emergency Department (ED) use. Associations between socio-demographic characteristics of patients and ED use were also analyzed.FindingsAfter 6 months, clinic patients had decreases in ED use that continued for twelve months, albeit to a lesser degree. Demographics and program services were not related to ED use; however, multiple associations existed between high ED utilizers, severe mental illness (SMI), substance use disorders (SUD) and non-retention in services.Research limitations/implicationsThe study lacked a comparison group and there was no distinction between avoidable and unavoidable ED visits. A small sample size across time points led to inconclusive post hoc findings.Originality/valueThis study explored effectiveness of primary care integration into a behavioral health clinic for persons with multiple morbidities. Although initial decreases in ED visits were present, results indicate that these models may not be effective for persons with SMI or SMI/SUD who are already high ED users. This study provides support for integrated care in reducing ED use among persons with multiple morbidities and calls for further research on designing effective integrated models for persons with SMI and SUD.

Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention.

2009 ◽  
Author(s):  
Christopher L. Hunter ◽  
Jeffrey L. Goodie ◽  
Mark S. Oordt ◽  
Anne C. Dobmeyer
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Integrated Behavioral Health

Barriers and facilitators to integrating behavioral health services and pediatric primary care.

2020 ◽  
Author(s):  
Keri J. S. Brady ◽  
Michelle P. Durham ◽  
Alex Francoeur ◽  
Cameron Henneberg ◽  
Avanti Adhia ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Behavioral Health ◽  
Barriers And Facilitators ◽  
Pediatric Primary Care ◽  
Behavioral Health Services
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