Team-based care: effective collaboration between PCPs and Behavioral Health Providers • Nurses, social workers, psychologists, psychiatrists, licensed
2012 University of Washington http://uwaims 1 COLLABORATIVE CARE CONSULTATION PSYCHIATRY: A CLINICAL ROTATION CURRICULUM FOR PSYCHIATRY RESIDENTS
Collaborative care programs are one approach to integration in which primary care providers, care managers, and psychiatric consultants work together to provide
Poor mental health is a major public health issue that robs millions of people of their The Collaborative Care Model is a patient-centered, population-
Collaborative care is delivered to low-income patients with medical and behavioral health needs, such as depression, PTSD, serious mental illness, and substance
A Solution: Better care coordination via integration of mental health and primary care has been shown to improve patient access and outcomes
Advancing Integrating Mental Health Solutions APA American Psychological Association CAHPS Consumer Assessment of Healthcare Providers and Systems
use issues and mental health issues other than depression, anxiety and alcohol use decision-makers who are working on solutions to problems with primary
Collaborative care for addiction mental health in primary the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS), and the Patient-Centered
Supported by funding from the Center for Integrated Health Solutions DRAFT developing role of a psychiatrist functioning as part of a collaborative care team
Collaborative care programs have been implemented by large health care The integration of physical and mental health care is Evidence-Based Solution
Supported by funding from the Center for Integrated Health Solutions DRAFT developing role of a psychiatrist functioning as part of a collaborative care team
shown the Collaborative Care Model (CoCM) to be more effective than AIMS Center, Advancing Integrated Mental Health Solutions, University of Washington -
Poor mental health is a major public health issue that robs millions of people of their chance The Collaborative Care Model is a patient-centered, population- AIMS Center: Advancing Integrated Mental Health Solutions: https://aims uw edu/
illnesses make it difficult to take care of themselves or their children. Untreated mental disorders
results in a staggering loss of productivity and an economic cost of more than $100 billion each year.ůƚŚŽƵŐŚĞĨĨĞĐƚŝǀĞƚƌĞĂƚŵĞŶƚƐĨŽƌŵŽƐƚĨŽƌŵƐŽĨŵĞŶƚĂůŝůůŶĞƐƐĞdžŝƐƚ͕ŵĂŶLJƉĞŽƉůĞĚŽŶ͛ƚƌĞĐĞŝǀĞ
the care they need. Most Americans with common mental health problems are exclusively seen by primary care providers who are often ill equipped to provide effective treatment. As few asŝŵƉƌŽǀĞŵĞŶƚ͘ĂƚŝĞŶƚƐǁŚŽĂƌĞƌĞĨĞƌƌĞĚƚŽĂŵĞŶƚĂůŚĞĂůƚŚƐƉĞĐŝĂůŝƐƚŽĨƚĞŶĚŽŶ͛ƚĨŽůůŽǁƚŚƌŽƵŐŚ
due to the stigma surrounding mental illness, the associated costs, or other barriers. As a result, only about a third of people diagnosed with a serious mental illness receive minimally adequate treatment.suffering from mental illness ǁŚŽĐƵƌƌĞŶƚůLJĂƌĞŶ͛ƚďĞŝŶŐƚƌĞĂƚĞĚďLJ
mental health professionals. Psychiatrists and other mental health specialists support primary care providers in familiar settings such as primary care clinics and school-based health centers, effectively bringing mental health treatment to where people feel comfortable receiving care. By providing systematic, caseload- focused consultation, psychiatrists can support evidence-based mental health care for a large number of people, thus closing the gap between what we know and what we can do for patients in need.ĐĂƌĞƐĨŽƌĂĚĞĨŝŶĞĚŐƌŽƵƉŽĨƉĂƚŝĞŶƚƐĂŶĚĐůŽƐĞůLJƚƌĂĐŬƐĞĂĐŚƉĂƚŝĞŶƚ͛ƐƉƌŽŐƌĞƐƐƵƐŝŶŐǀĂůŝĚated
clinical rating scales (e.g., PHQ-9 for depression). Treatment is systematically adjusted if patients
ĂƌĞŶŽƚŝŵƉƌŽǀŝŶŐĂƐĞdžƉĞĐƚĞĚ͘ĂƚŝĞŶƚƐǁŚŽĚŽŶ͛ƚƌĞƐƉŽŶĚƚŽƚƌĞĂƚŵĞŶƚĂƌĞƌĞĨĞƌƌĞĚƚŽŵŽƌĞ
intensive mental health specialty care. Psychiatric consultations are largely done via phone with͚ƐƚĞƉƉĞĚĐĂƌĞ͛ĂƉƉƌŽĂĐŚĐĂŶŚĞůƉŽǀĞƌĐŽŵĞƚŚĞĐůŝŶŝĐĂůŝŶĞƌƚŝĂƚŚĂƚŝƐŽĨƚĞŶƌĞƐƉŽŶƐŝďůĞĨŽƌ
patients continuing on ineffective treatment.experiences, better clinical outcomes, and lower health care costs. It is estimated that an
effective implementation of Collaborative Care for Medicaid members would result in approximately $15 billion per year in savings.Mental health and patient-ĐĞŶƚĞƌĞĚ͕ĂĐĐŽƵŶƚĂďůĞĐĂƌĞĂƌĞŽŶƚŚĞŶĂƚŝŽŶ͛ƐƌĂĚĂƌĚƵƌŝŶŐƚŚŝƐƚŝŵĞ
of Health Care Reform. In this context, psychiatrists and other mental health specialists who are prepared to support a caseload of patients treated in primary care are valuable commodities. Collaborative Care Model also creates new opportunities for Community Mental Health Centersand other mental health specialty providers to offer consulting and treatment services in
partnership with community health centers and other primary care practices. As more and more large-scale implementations of Collaborative Care get underway (such as the New York State Collaborative Care Initiative, the Depression Improvement Across Minnesota: Offering a New Direction (DIAMOND), the CMMI-funded seven-state COMPASS Initiative, and WashingtonƚĂƚĞ͛ƐĞŶƚĂůĞĂůƚŚŶƚĞŐƌĂƚŝŽŶƌŽŐƌĂŵͿ, we will need a pool of qualified psychiatrists versed
in Collaborative Care.