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Throughout the years public health efforts have evolved in order to meet health care need of populations. Despite advances the United States continues to have high morbidity rates of individuals with chronic illness. Adding to the rates, many Americans are suffering from mental health disorders. The issue caused many research studies to focus on integrating behavioral health and primary care in order to reduce health disparities in the nation. This paper will analyze how the integration of behavioral health in primary care facilities help serve the need of our population.

Martin, Whiting & Jackson 5th Edition - Human Resource Practice – Recruitment & Selection – Assessment Centres Pg 140

The final item of business brought up was the vision for system integration in behavioral health. There was plenty of discussion focused on this since it is a new introduction but a much needed policy that needs to be put into place. Included in this discussion was the possibility of implementing behavioral health homes in Nebraska. Many other states have implemented behavioral health homes and some have worked out well and others have failed. One member brought up the big picture concern of behavioral health homes and how they are to take care of those with multiple morbidities since they are very complicated patients and healthcare workers tend to shy away from them. Nobody knew the answer to solve this concern but the committee planned how they should be thinking about what approach to take to make the behavioral health system more integrated. Today’s discussion about the vision for system integration was just the beginning of what is going to be handled at the next meeting.

Rivers Integrated Care (RIC) is a primary care facility located in Phoenix Arizona. This clinic recently transitioned from an urgent care facility to an integrated primary care and emergency clinic. The goal of this transition is to become a patient-centered medical home and behavioral health facility. The clinic currently has a Behavioral Health Consultant, who is also the Site Administrator, Physician Assistant (PA) and a Primary Care Provider (PCP). The plan is to employ a full-time Psychiatrist to prescribe psychotic medication. Although employees of RIC consider this clinic a fully integrated facility. According to the Agency for Healthcare Research and Quality's (AHRQ) integration assessment tool, the clinic is partially integrated.

In Clinical Integration in Strategic Planning “providers can track the patient across the continuum, coordinate care across the continuum and make sure the patient is getting the most appropriate care in the most appropriate environment” (Karash & Larson, 2016). It is needed to simplify the direction/coordination of patient care through any circumstances, providers, sceneries, and time in order to attain care that is harmless, appropriate. effectual, well – organized, reasonable and patient-focused. In addition, clinical integration also develops the partnership with the physician, an administrator developing the partnership with the team. Clinical integration starts from the top board of

Behavioral health care is a broad term that entails treating patients with any mental health or substance use condition, as well dealing

Heritage Oaks Hospital provides a less restrictive step-down treatment environment at three outpatient centers: Harbor Oaks in West Sacramento serves adults and senior adults; Roseville Oaks serves adolescents, adults, and senior adults; and Winding Oaks next to the main hospital serves adults and senior adults. According to course textbook, the goal of outpatient programs is to improve quality of life and to return clients to daily activities among family, peers, and the community (Varcarolis, 2013). The treatments available include psychiatric, emotional, behavioral, and substance abuse. These outpatient centers have partial hospitalization program (PHP) and intensive outpatient program (IOP). According to the hospital website, outpatient services include physician oversight, medication management, group therapies, educational practices such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) (heritageoakshospital.com, 2017). I was assigned to Roseville Oaks Outpatient Behavioral Health Center. It was helpful for me to

When two organizations come together to build one, it can become very successful. Physicians are more involved then hospitals and this is because they bring in all the patients, are treating the patients, ordering the supplies, choosing the staff and must deal with all the complaints and comments from patients and their families. The way care is delivered depends on how the physicians and hospitals work together. It is essential that the two organizations focus on improving quality, costs, outcomes, access, and patient satisfaction. There are strategies that can be followed to help hospitals integration with physicians become more successful. The 12 strategies to guide integration efforts are:

The Behavioral Health Division is a county operated program that is contracted with several community agencies to provide short term and long term treatment for the emotional and mental-ly challenged residents of Milwaukee County. As revealed by intensive research the mental health system in Milwaukee County needs to be reformed. The current system is a direct result of state laws drafted by public defenders in the mid-1970, which ultimately has lead today’s cri-sis.

Building upon the knowledge gained in its previous attempts, over the next several years, IHC went about creating the infrastructure necessary to support such a model. IHC reorganized its management teams to include “a clinical administrative structure to be the clinical counterpart of the administrative structure at each level of the organization” (Bohmer, 2002). Guidance Councils (consisting of a physician leader and nurse manager) were formed for each clinical program and were responsible for coordinating program goals, management strategies and data collection across the system. Within the Guidance Councils were interdisciplinary Development Teams who identified “the key work processes and medical conditions for which protocols should be developed”, then created, implemented and refined said protocols (Bohmer, 2002). This was made possible by engaging practicing physicians (who were wisely reimbursed for their time) in the process, which gave them both the direct experience of the systems they created (be it paper or computer) and a provided feedback loop within the clinical community. Furthermore, IHC created a culture around process improvement, organizing “everything around value-added (front line) work processes” while offering “extensive training in clinical process improvement” as well as operational process improvement (Clark, 2010).

What is behavioral healthcare? In Psychology Today (online) Master of Public Health Elana Premack Sandler observes that behavioral health is promoting the well-being of clients “by preventing or intervening in mental illness”, substance abuse, as well as it focuses on decreasing the stigma that surrounds the term mental health (2009). Behavioral health includes: finding what works best for a patient, include that patient in the plan of care, and be attentive in improving the behavior that is causing issues or habits. Hippocrates was one of the first to treated people with mental illnesses aside from religious beliefs or the stigmata of sorcery (Unite for Sight, n.d.). Behavioral health professionals and services have come a long way from the time of Hippocrates.

The SVMC ED cares for 18,000 patients a year and has seen an increase by 2% a year for the past five years. Of those patients seen in the ED, approximately 20% are for substance abuse or mental health issues (St. Vincent’s Medical Center [SVMC], 2018). Patients presenting with mental health or substance abuse issues are medically cleared in the ED and treated in the Behavioral Health Unit (BHU). The BHU is managed by the Behavioral Health Service Line and staffs the unit with dedication behavioral health professional. Psychiatrist coverage is only provided during business hours, resulting in patient boarding in the ED overnight waiting for a Psychiatric consult and evaluation. This proposal suggests implementing a telepsychiatry program to

It is a pleasure taking this class with you. I absolutely agree with your perspectives that this class provides the necessary foundation to develop and manage a behavioral health program. The Vermont Integration Profile (VIP) tool is an excellent tool for this class. Just like you stated the tool is valuable and it provides great information for behavioral health consultants, primary care providers and anyone interested in integrating care.

Information will be gathered by the distribution of two distinct surveys. One would be distributed through management at the Roanoke branch to a proper sampling of personnel at both management and non-management positions and the other would be distributed to points of contact with selected long-term clients. The following are samples of the types of questions that will appear on these respective surveys.

Another study was designed a bridge program to assess the effectiveness of an educational program for adults with serious mental illness. A control group received normal treatment in their regular mental health facility consisting of “medication management, case manager, 1:1 group counseling, and daily activity groups” to vigorously involve the participants in a variety of life skill intervention groups. (p. 248) 2 times per week for a total of 6 weeks. The bridge programs were held