Dr. Richard Cohen
Director, Behavioral Health Metro Community Health Centers

Richard CohenPrimary Care Settings have become a gateway for many individuals with behavioral health and primary medical care needs. To address these needs, many primary care providers are integrating behavioral health care services into their settings. Models have emerged that include the use of care managers, behavioral health providers, behaviorists, or consultants.

Most primary care organizations underestimate the real impact behavioral health has on their bottom line in terms of clinical productivity. For example, if a patient comes in for a short 10 minute visit and finds out he or she has diabetes, that appointment can easily become a 50 minute visit. Most of those extra 30 minutes are taken up with psychosocial concerns, which could be more effectively served by a behavioral health professional than the primary care provider.
What does integrating behavioral health into their center look like? A Primary Care Physician (PCP) and a behavioral health specialist (Psychologist, Licensed Clinical Social Worker or Psychiatrist) work as a team, huddling in the morning to discuss the day’s schedule, which helps them conduct warm hand-offs as the day progresses. Staff should be knowledgeable in the use of motivational interviewing and screening tools, including Patient Health Questionnaires for Depression, Generalized Anxiety Dis-order and drug or alcohol screens. There should also be an Assessment and Referral program model, which involves a brief assessment, a master treatment plan, sessions with the behavioral health specialist, and then referral to other specialists if further treatment is needed. A formal communication structure, including a messaging system through the EHR, a newsletter, robust communication with outside referral sources and monthly problem solving meetings among staff are essential.

MCHC is in the midst of expanding access to Behavioral Services for our patients and their families. This initiative is a core component of our goal to provide a system of care that recognizes, treats and supports each patient’s physical, mental and social health. The result—healthier, happier patients, more effective and efficient use of our provider community and possible lower cost of care.