PP214 – Brief Integrated Behavioral Health Services in the Primary Care Setting
Integrated behavioral health is care that results from a team of primary care and behavioral health clinicians working with patients and families to provide patient-centered care for a defined population (Agency for Health Research and Quality, 2019). In March 2018, the University of North Carolina (UNC) Health Alliance implemented a brief integrated behavioral health model to increase access to behavioral health services for patients treated in primary care practices. Practice data supports that depression and/or anxiety contribute to 80% of UNC’s ambulatory behavioral health visits.
Behavioral health services are provided by an LCSW case manager embedded in the primary care practice. The focus of treatment is “here and now” with goals to improve patient functioning, reduce behavioral health symptoms, and improve management of medical and behavioral disorders. Patients with severe and persistent mental illness are followed for episodic case management to bridge to behavioral health specialist services. Patients are typically seen for 5-12 visits spread over a 6-month period. The LCSW systematically tracks PHQ9 and GAD7 screenings to monitor for reduction in symptoms. LCSW interventions include Problem-Solving, Solution-Focused Therapy, Cognitive Behavioral Therapy, Motivational Interviewing, Mindfulness Based Stress Reduction, and psychoeducation. A psychiatrist with specialty in integrative behavioral health provides consultation to LCSWs and primary care providers. LCSWs are credentialed and enrolled with major payers and bill for services. Future state is to further increase access by providing virtual behavioral health services for rural and underserved areas.
Positive outcome data regarding PHQ9 and GAD7 screening scores contributing to depression management and response will be presented. Lastly, we will describe lessons learned in the implementation of the model, including selection of qualified staff and provider engagement strategies.