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Effective Bi-Directional Integration: Evidence Based & Best Practices

Effective Bi-Directional Integration: Evidence Based & Best Practices. Presented by: Kathleen Reynolds LMSW ACSW kathyr@thenationalcouncil.org. Why bi-directional integration?. Persons with serious and persistent mental illness die, on average at the age of 53.

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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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