Department of Behavioral Health and Intellectual disAbility Services June 25, 2013

1. Department of Behavioral Health and Intellectual disAbility ServicesJune 25, 2013 Eleventh Street Family Health Center 0f Drexel University Patricia Gerrity, RN PhD, FAAN

2. B

3. Community Partnership • Started 1996 • Residents of four public housing developments in Lower North Philadelphia • Community Driven • Had to develop trust • Community was tired of being assessed and surveyed

4. Just cause you’ve got the recipe doesn’t mean you’ve got the cake

5. “Man is the only animal that cries because man alone sees the difference between what is and what could be” Victor Hugo

6. 11th Street Family Health Services of Drexel University In partnership with the Family & Practice & Counseling Network

7. Development Based on NeedsPopulation Focused

11. Original Study vs 11th St Results

13. Integrative Health Care To create a seamless engagement by patients and caregivers of the full range of physical, psychological, social, preventive, and therapeutic factors known to be effective and necessary for the achievement of optimal health throughout the lifespan.

14. Primary Care Redesign • More than adding services to primary care, or simply adding traditional mental health philosophies, skills & interventions in a new setting • Requires systems redesign • Providers shift from independent clinician to a functioning team member • Each member of the team must understand enough about the discipline & training of team members to communicate effectively and to design collaborative interventions that will meet the needs of the patient.

15. Every great change must expect opposition because it shakes the very foundation of privelege.Lucretia Mott

17. Integrated Team • Family nurse practitioner • Clinical nurse • Primary behavioral health consultant • Child & adult • Couples & Family Therapist • Generalist social worker • Health educator • Nutritionist • Complementary & integrated therapist • Physical therapist • Fitness trainer • Nurse family partnership home visitors • Creative arts therapists • Attorneys

18. Characteristics of Integrated care • High degree of collaboration and communication • Establish comprehensive treatment plan to address biological, psychological and social needs of patients

19. Shared Language • Project LEAP- Learning through Effective Ambulatory Practices • Integrated care • Complementary & integrative therapist • Architects- engagement room (ER)

20. Lexicon for Behavioral Health & Primary Care • Peek CJ and the National Integration Academy Council AHRQ Pub No 13-IPOOO1-EF

21. What is it? • The care that results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systemic and cost effective approach to provide patient centered care for a defined population.

22. The care may address • Mental health conditions • Substance abuse • Health behaviors • Life stressors and crises • Stress related physical symptoms • Ineffective patterns of health care utilization

23. How • A practice team tailored to the needs of each patient and situation • With a shared population and mission • Using a systematic clinical approach ( and a system that allows the clinical approach to function)

24. Supported by • A community, population, or individual expecting that behavioral health and primary care will be integrated as a standard of care • Supported by office practice, leadership alignment, and business model • Continuous improvement and measurement of effectiveness

25. All Services at 11th Street FHS

26. Primary Care

27. Microsystems • A small interdependent team defined at the level of each patient that forms to meet particular patient and family needs • The microsystem changes as the needs of the patient and family shift

28. Creative Arts Therapies Creative Arts Therapies (CATs) are the psychotherapeutic use of movement/dance, music and art to further the emotional, cognitive, physical and social integration of the individual. CATs are behavioral health therapists who integrate evidence from fields like neuroscience, human development and behavior, counseling, psychopathology and multiculturalism to develop their practice of assessment and treatment. Both individual and group therapy is provided. CATS serve as primary counselors for our patients, and treat in conjunction with talk therapists, physical therapists, nurse practitioners and the nutritionist, for example.

29. Social Work

30. Pharmacy

31. Dental

32. Physical Therapy

33. Health Education Outreach

34. Behavioral Health, FPCN • Licensed social workers, psychologists and psychiatrists offer diagnostic assessments; psychiatry services including medication evaluation and management; short-term or long-term individual talk therapy for adults and talk and play therapy for families, children (ages 4 and up) and adolescents.

35. Behavioral Health Programs • Co-located outpatient behavioral health • BHC Adult • ESBIRT • Trauma • BHC children & families • Creative arts therapy • Complimentary therapies • MBSR • Yoga • Mediation • Chronic pain- Power Over Pain • Intensive Care Management

36. Adult BHC

37. SBIRT • Screening, Brief Intervention, & Referral to Treatment • Collaboration with the Treatment Research Institute

38. SBIRT • Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment. • Brief intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change. • Referral to treatment provides those identified as needing more extensive treatment with access to specialty care.

39. Power Over Pain • Chronic Pain Resource Center • You are worth more than your pain! Empower yourself to be well! Goals: • Learn how to live with chronic pain. • Managing the different aspects of pain experience. • Create a safe and open learning environment where there is no judgment. • To empower patients to manage their own pain when they are at home doing the things they want to do.

40. Power Over Pain • Clinical nurse • Behavioral health consultant • Physical therapist • Complimentary & integrative therapist • Creative arts therapists • Dance /movement

42. The Goals of The Porch Light Initiative Shed light on challenges faced by those with behavioral health issues, reducing stigma and encouraging empathy among fellow community members Create a network of services for the benefit of individuals and families that heightens awareness of behavioral health resources and increases access to treatment Build a team of artists, service providers, individual participants, and other stakeholders that collaborate on transformative public art projects which encourage community ownership and pride and catalyze positive changes in neighborhoods 

43. Adult BHC • Monitoring and supporting people with chronic physical illnesses • Care management for depression or other behavioral conditions • Skills in patient activation, goal setting, motivational interviewing and fostering health behavior change. • SBIRT- Treatment Research Institute

44. Dance Movement Therapy with Lindsay Meeks

45. Fitness Center

46. Yoga with Kathleen Guidotti

47. Pediatric Team • Behavioral health consultant PsyD • Family & child supports coordinator • FamilyNurse Practioner • Midwife • Resilience

48. Pediatric BHC

49. Centering Model • Incorporation of • Assessment • Education • Support • Provided by an interdisciplinary team in a group setting

50. Visit for Mother and Baby