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Treating the mind and body together

Tuesday, July 15, 2014

Mental health specialists integrated into medical group practices

”We know that people with medical problems get better faster—and stay better longer—if they also get treatment for their depression or anxiety. Allen Miller, Ph.D., director ofEach year, one in four Americans experiences a behavioral health illness or problem with substance abuse.

WellSpan Medical Group and WellSpan Behavioral Health Services are teaming up to put mental health specialists in medical group practices.

“This is more than just a co-location of services,” said Allen Miller, Ph.D., director of WellSpan Behavioral Health. “We’re integrating behavioral health clinicians into the treatment teams of Patient-Centered Medical Homes.”

The pilot program began in February at Apple Hill Internal Medicine and Wheatlyn Family Medicine. In the coming months, five more practices will be added.

“We know that people with medical problems get better faster—and stay better longer—if they also get treatment for their depression or anxiety,” Miller said.

The pilot program uses doctoral interns in clinical psychology. They go by the title “behaviorist” to soothe patients who might balk at seeing a psychologist.

Chris Echterling, MD, said he introduces a behaviorist just as he would a nurse or dietitian. “I say, ‘Hey, I have someone on my team who’s really helped other patients cope with this same kind of problem. I have great confidence they can help you, too. Would you like to meet him?’”

Echterling is an associate medical director for quality and innovation at WellSpan Medical Group. He also oversees Bridges to Health, a WellSpan program for people with a history of a high number of emergency department visits and hospitalizations. At Bridges to Health, a behaviorist has been helping patients since 2012.

Depression and anxiety are normal human responses to a difficult situation, Echterling noted. He spoke of a patient who was severely injured by a hit-and-run driver and remains unable to work. The man copes daily with physical pain and crushing financial pressure.

“Whether or not he had mental health issues before all this happened, he certainly has them now,” Echterling said.

Treating the mind and body together can yield significant results. A health system in Des Moines, Iowa, found that 79 percent of readmitted patients had a behavioral disorder complicating their physical condition. When psychologists intervened, the readmission rate fell 8 percent in just two months.

At WellSpan’s pilot sites, medical staff have become more adept at spotting and addressing behavioral problems, Echterling said.

“They talk to the behaviorist about how to handle one patient, and then they incorporate those techniques for future patients,” he explained.

Karen Jones, MD, FACP, is vice president and chief medical officer of WellSpan Medical Group. She believes this innovation will reduce costs and improve the patient experience.

The challenge, she said, will be convincing insurers, so the pilot program needs to produce measurable outcomes.

“The behavioral health piece of our care redesign is going to be huge,” Jones predicted. “This is absolutely where we need to go. The early signs are very promising.”

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