Effective BiDirectional Integration Evidence Based Best Practices Presented

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 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: l l l Homelessness Victimization / trauma Unemployment Poverty Incarceration Social isolation

Model of Bi-Directional Integration

Models – Bi-Directional Integration Behavioral Health –Disease Specific • • • IMPACT RWJ Mac. Arthur 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)

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)

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: Ph. D, LMSW, LPC, BSW, Consumers • Electronic Medical Records • Registries • Bridging the professional culture gap