Integrating Behavioral Health into Primary Care

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Original story posted on: July 23, 2018

Integrated approach targets both the physical and mental health needs of patients.

Up to one in four primary care patients suffer from depression. And some recent studies have shown surprising ties between cardiac health and mental health.

Yet for many people, it is difficult to find quality mental health resources in the community. Sometimes, patients don't follow through with referrals to mental health professionals due to costs and stigma. Additionally, there is a shortage of care providers, which can make finding one difficult and frustrating. Patients may also feel embarrassed about their issues and not want to seek help, or they simply don’t realize the symptoms they are experiencing are tied to an underlying mental health issue.

Primary care settings are the entry point for many individuals with both behavioral health and primary care needs. Research has shown that people are more willing to consider treatment when offered in a familiar and comfortable setting. As a result, we are integrating behavioral health services into primary care settings to address these needs.

In November 2016, Sheppard Pratt Health System, Greater Baltimore Medical Center (GBMC) and Kolmac Outpatient Recovery Centers teamed up to launch Sheppard Pratt Integrated Behavioral Health at GBMC, a program that integrates behavioral health services into patient-centered medical home primary care practices. Sheppard Pratt Health System is the largest private, non-profit provider of mental health, substance use, special education, developmental disabilities and social support services in the country.

Currently, there is a full-time Sheppard Pratt behavioral health consultant at nine of 10 primary care practices to provide mental health evaluations and treatments; we also have a part time psychiatrist and part time addictions counselor in every clinic. Through this integrated effort, when a patient has symptoms of a behavioral health issue, they can now access a Sheppard Pratt provider right down the hall instead of having to be referred to someone in the community.

This holistic approach ensures patients are able to get the care they need, right where they are. It also helps keep patients healthy and out of hospitals and emergency rooms. Integrative care fosters the Triple Aim: better outcomes, lower costs, and a better patient experience.

This program and partnership have shown tremendous success since its launch. In the little over a year since it began, anxiety scores were reduced by 52 percent and depression scores by 36 percent based on 2,000 assessments. Eighty-six percent of behavioral health appointments have been completed in these primary care practices, compared to 50 percent nationally. 46,000 patients have completed a formal substance abuse screen. Patients show up for the services, 68 percent of patients keep their appointment, and the no show rate is about 10 – 13 percent—better than for general mental health care nationwide.

By targeting both the physical and mental health needs of patients, we can recognize all of the issues impacting their health and improve their quality of life.


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Catherine Harrison-Restelli, MD

Dr. Catherine Harrison-Restelli is a psychiatrist with Sheppard Pratt Health System and Chair of the Department of Psychiatry at Greater Baltimore Medical Center. Dr. Harrison-Restelli appeared on the June 26, 2018 Talk Ten Tuesday broadcast.

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