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Effective Bi-Directional Integration: Evidence Based & Best Practices

Explore the importance of bi-directional integration for mental health and physical health, highlighting key factors, models, and successful strategies presented by expert Kathleen Reynolds. Learn how to implement effective practices to bridge the gap between behavioral health and primary care.

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Effective Bi-Directional Integration: Evidence Based & Best Practices

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  1. Effective Bi-Directional Integration: Evidence Based & Best Practices Presented by: Kathleen Reynolds LMSW ACSW kathyr@thenationalcouncil.org

  2. Why bi-directional integration?

  3. Persons with serious and persistent mental illness die, on average at the age of 53 • Higher Rates of Modifiable Risk Factors: • Smoking • Alcohol consumption • Poor nutrition / obesity • Lack of exercise • “Unsafe” sexual behavior • IV drug use • Residence in group care facilities and homeless shelters Vulnerability due to higher rates of: • Homelessness • Victimization / trauma • Unemployment • Poverty • Incarceration • Social isolation

  4. Model of Bi-Directional Integration

  5. Models – Bi-Directional Integration Behavioral Health –Disease Specific • IMPACT • RWJ • MacArthur Foundation • Diamond Project • Hogg Foundation for Mental Health • Primary Behavioral Healthcare Integration Grantees Behavioral Health - Systemic Approaches • Cherokee Health System • Washtenaw Community Health Organization • American Association of Pediatrics - Toolkit • Collaborative Health Care Association • Health Navigator Training Physical Health • TEAMcare • Diabetes (American Diabetes Assoc) • Heart Disease • Integrated Behavioral Health Project – California – FQHCs Integration • Maine Health Access Foundation – FQHC/CMHC Partnerships • Virginia Healthcare Foundation – Pharmacy Management • PCARE – Care Management Consumer Involvement • HARP – Stanford • Health and Wellness Screening – New Jersey (Peggy Swarbrick) • Peer Support (Larry Fricks)

  6. What do we know about what works? • Three strategies have been identified in a meta-analysis of successful integration programs • A consulting psychiatrist • A primary care provider prescribing all meds • Care coordination (Gilbody, 2006)

  7. Additional Implementation Strategies for Bi-directional Integration • Partnerships between behavioral health and primary care or “do it yourself” • Financing: Maximize existing billing options to fund integrated care • Staffing: PhD, LMSW, LPC, BSW, Consumers • Electronic Medical Records • Registries • Bridging the professional culture gap

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