Implementation of Integrated Behavioral Health Care in a Large Medical Center: Benefits, Challenges, and Recommendations
- PDF / 221,718 Bytes
- 17 Pages / 496.063 x 720 pts Page_size
- 75 Downloads / 177 Views
rnal of Behavioral Health Services & Research, 2020. 1–16. c 2020 National Council for Behavioral Health. DOI 10.1007/s11414-020-09742-0
Integrated Care: Benefits and Challenges
PROM ET AL.
team dynamics, and financial and interdepartmental issues. The findings suggest that IBHC implementation barriers in existing large health systems risk diminishing potential benefits and successful adoption. These barriers can be combated by incorporating systems change strategies into implementation frameworks, with a focus on barrier prevention and detection and long-term sustainability.
Introduction In 2018, fewer than half (43.3%) of the 47.6 million adults (19.1%) with mental illness in the USA received behavioral health services during the previous year.1 Integrated behavioral health care (IBHC) within primary care settings (or “integrated care”) is an increasingly supported method of addressing the unmet needs of traditional behavioral health models (i.e., specialist care models). The term “integrated behavioral health care (IBHC)” covers a range of models that vary in their implementation and participating providers—from co-location of a behavioral health provider to fully integrated collaborative care management, including roles such as behavioral health care managers, therapists, and psychiatric consultants. IBHC is particularly positioned to address unmet patient behavioral health needs where the barrier to care is lack of access to specialized behavioral health services or patients’ reluctance to accept traditional behavioral health care (due to factors such as time, location, stigma, cultural barriers, and somatic expression of distress). These behavioral health needs include both mental health and substance use disorders. IBHC is intended to enhance system efficacy, reduce health care fragmentation and costs, and improve access, quality of care, and consumer satisfaction.2 It allows patients to access care in a familiar setting, and utilizes already existing relationships with primary care providers, the latter of which could potentially reduce stigma and overcome cultural barriers to accessing behavioral health care.3–5 Additionally, IBHC is well suited to address the burden of co-morbid behavioral health conditions and chronic medical illness, as IBHC has been demonstrated to improve outcomes for both chronic medical and behavioral health conditions, as well as improve patient satisfaction with care.6–9 There is overwhelming evidence that supports IBHC models. It has demonstrated benefits in patient outcomes as compared to usual care, including adherence to treatment, improved satisfaction with care, quality of life, functional status, social role function, and remission and recovery of psychiatric symptoms, including in diverse patient populations.4,6,10–19 Additionally, evidence suggests that IBHC can improve outcomes while also being more cost-effective.20–24 While the research support for IBHC is strong, the published research studies have been limited to specific types of IBHC models, patient populations, and be
Data Loading...
