Integrating Behavioral Health and Primary Care
Integrating Behavioral Health and Primary Care
Professor of Psychiatry and Vice Chair
Assistant Clinical Professor of Medicine
Licensed Clinical Social Worker
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Abstract
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.
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Front Matter
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Part I Models of Integrated Care
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1
Conceptual Framework for Integrated Care: Multiple Models to Achieve Integrated Aims
Alexis A. Giese andMaryann Waugh
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2
Integrated Health Care at Cherokee Health Systems
Parinda Khatri and others
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3
Canadian Approach to Integrated Care
Nick Kates andEllen Anderson
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4
Team-Based Integrated Primary Care
Tziporah Rosenberg and others
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5
The Patient-Centered Medical Home
Colleen Conry and others
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6
Financing Integrated Care Models
Bruce J. Schwartz and others
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7
Integrating Physical and Mental Health Care in the Veterans Health Administration: A Path to the Future
Lisa V. Rubenstein
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8
Aging Brain Care: A Model of Integrated Care for Dementia and Depression
Catherine A. Alder and others
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9
Telehealth in an Integrated Care Environment
Debbie Voyles and others
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10
Automated Mental Health Assessment for Integrated Care: The Quick PsychoDiagnostics Panel Meets Real-World Clinical Needs
Jonathan Shedler
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1
Conceptual Framework for Integrated Care: Multiple Models to Achieve Integrated Aims
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Part II Integrative Care for Psychiatry and Primary Care
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11
Integrated Care for Anxiety Disorders
Robert D. Davies and others
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12
Treating Depression and Bipolar Disorder in Integrated Care Settings
Christopher Schneck
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13
The Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Integrated Primary Care
Elizabeth Lowdermilk and others
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14
Treating Substance Use Disorders in Integrated Care Settings
Patricia Pade and others
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15
Integrated Care for Binge Eating and Other Eating Disorders
Joel Yager and others
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16
Treating Somatic Symptom Disorder and Illness Anxiety in Integrated Care Settings
Alla Landa and others
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17
Working with Personality Disorders in an Integrated Care Setting
Robert E. Feinstein andJoseph V. Connelly
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18
Violence and Suicide
Robert E. Feinstein
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11
Integrated Care for Anxiety Disorders
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Part III Integrated Care for Medical Subspecialties and Behavioral Medicine in Primary Care
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19
Integrative Care Model for Neurology and Psychiatry: Non-Epileptic Seizures Project
Lynne Fenton and others
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20
Women’s Mental Health Across the Reproductive Lifespan
Noa Heiman and others
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21
Assessing and Treating Sexual Problems in an Integrated Care Environment
Kenneth M. Pollock andAlan M. Altman
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22
Wellness: An Integrated Care Approach
Meegan Lipman and others
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23
Integrated Chronic Pain and Psychiatric Management
Robert M. McCarron and others
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24
Death and Dying: Integrated Teams
Anne A. Brewer andJoseph V. Connelly
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19
Integrative Care Model for Neurology and Psychiatry: Non-Epileptic Seizures Project
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Part IV Psychosocial Treatments in Primary Care and Medical Specialty Clinics
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25
Health Coaching in Integrated Care
Marilyn S Feinstein andRobert E. Feinstein
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26
Crisis Intervention in Integrated Care
Scott A. Simpson andRobert E. Feinstein
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27
Best Practice for Family-Centered Health Care: A Three-Step Model
Joanna Sturhahn Stratton and others
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28
Group Interventions in Integrated Care Settings
Brian Rothberg andHillary D. Lum
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25
Health Coaching in Integrated Care
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End Matter
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