30 Dec What is Integrated Mental Health Care?

Evidence-based collaborative care programs are patient-centered and provide integrated care for medical and mental health needs in primary care and other mental health settings. Over 30 studies have found such programs to be more effective than usual care of for mental disorders such as depression and anxiety. 

Offering mental health treatments in primary care is convenient for patients. It can reduce the stigma associated with treatment for mental disorders, builds an existing provider-patient relationship, and can help improve care for the millions of patients who have medical and mental disorders. Such integrated care has shown to be more cost-effective than care as usual.

Effective collaborative care programs go beyond co-locating a mental health professional in a primary care clinic. They use established principles of chronic illness care and collaborative care teams in which professionals with complementary skills work closely together to care for a population of patients with mental problems. Clinic staff trained as care managers work closely with the patients primary care provider to help engage and support patients in treatment, track clinical improvement over time, and support medication management by primary care providers. They also track the care using an outcomes-driven medical record that allows for the recording of treatment services driven by evidence-based therapy.

Principles of Care:

The core principles of effective integrated behavioral health care include a patient-centered care team providing evidence based treatments for a defined population of patients using a measurement-based electronic medical record.

• Patient-centered care: Primary care and behavioral health providers collaborate effectively using the same electronic medical record.
• Population based care: Care team tracks a defined group of patients in an outcome-driven automated software program.  Practices track and reach out to patients who are not improving, and mental health specialists provide a treatment plan focused therapy, not just ad hoc advice.
• Measurement based treatment to target: Each patient’s treatment plan clearly articulates personal goals and clinical outcomes that are routinely measured. Treatments are adjusted if patients are not improving as expected.
• Evidence-based care: Patients are offered treatment for which there is credible research evidence to support their efficacy in treating the target condition.
• Accountable care: Providers must be able to demonstrate, through the use of an electronic medical record, that their program works before they are paid.

Core components and tasks are shared by effective integrated behavioral health care programs. Through the use of an electronic medical record, organizations build clinical workflows that incorporate the core components and tasks that are unique to their setting. 

Integrated mental health care is not only good medical practice, it’s a standard of care that the business of health care is moving toward.