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A TIME OF CHALLENGES: knowing when help is needed, D2 SUICIDE RATES ON THE INCREASE: stats tell a tragic story, D3 STRESS: healthy ways to relieve it throughout the day, D4
| SUNDAY, SEPTEMBER 22, 2019
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Physical and behavioral health conditions often occur hand-in-hand. Today, over two-thirds of adults with a behavioral health condition also have a medical condition - but the country’s fragmented health care system makes it difficult for these individuals to receive treatment that takes both areas of their health into account.
By Gillian I. Follett
Special to The Republican
Having the different aspects of their health care scattered among various medical providers can reduce the effectiveness of an individual’s overall care and significantly raise their medical costs. For over a decade, linking individuals’ physical and behavioral health* care has been at the heart of Behavioral Health Network’s mission. For the past two decades, the rate of co-occurring medical and behavioral health conditions has increased dramatically around the globe, especially among children, teens, and the elderly. In order to more effectively treat individuals with co-occurring conditions, BHN is among a growing number of nonprofits working to implement a “whole health” model by partnering with primary care providers to ensure that all of an individual’s conditions, medical or behavioral, are considered when creating a treatment plan. This approach largely centers on integrating behavioral health services into primary care locations to make it easier for doctors to connect patients to these services. “For the past ten years, we’ve been looking at how to be an integral part of health care as a system,” said Kathy Wilson, the chief executive officer and president of BHN. “Now, we work with health care providers as partners. Doctors need us, and we need them. We make sure we focus on the whole person, and not just the disease.” The whole health care model is based on the Institute for Health Care Improvement’s “Triple Aim” framework, which proposes a threepronged solution to modify the current health care system: 1) improving patient experience in terms of quality and satisfaction;
2) improving the population’s overall health; and 3) reducing individual health care costs. The Institute also promotes the expansion of primary care to include behavioral health care and social services to ensure individuals’ needs are effectively met at the lowest possible out-of-pocket cost. For the past few years, Massachusetts has been supporting an initiative to incorporate the Institute’s ideas into the state’s health-
developed several programs that involve medical organizations, such as Baystate Health and Holyoke Health Center, in individuals’ care. At each partner site, BHN employees are available to help patients who share concerns about their mental health or substance use with their doctor. “A doctor may determine that their patient needs a behavioral health specialist to work on things that are contributing to the patient’s challenges managing their physical
sistants depending on the patient’s needs. BHN’s behavioral health specialists can assist individuals in managing a variety of behavioral conditions, including substance use disorders or mental illnesses such as depression or anxiety. When a doctor at one of the sites— Baystate Health, for instance— decides that their patient needs additional behavioral health care, they direct them to one of BHN’s on-site behavioral health specialists,
“Sometimes it’s as simple as having a therapist at the doctor’s office for a couple of days each week so the doctor can refer patients to them,” DeFlumer-Trapp said. “And sometimes it’s as intensive as having the behavioral health specialist serve as a member of the doctor’s team and work directly with the primary care provider in a patient’s treatment.” BHN has also developed a range of programs outside of these primary care sites that blend together patients’ physical and mental health care. Behavioral health specialists, such as outpatient clinicians, home health aides and care managers, work together to act as a “wraparound” support system for individuals that addresses any gaps in their treatment plans. For individuals with substance use disorders, BHN offers detox programs and residential recovery homes. BHN has also implemented services based on the state’s Children’s Behavioral Health Initiative that address children’s behavioral health needs at all ages, both at home and at school. According to DeFlumer-Trapp, BHN’s increasing focus on integrating behavioral health care with physical wellness has developed in response to changes in how health care is viewed in the professional world. Assistant Program Director Sophia Barker, LCSW, and clinician Maria Leger, LMHC, of Behavioral Health “Behavioral health has been Network work on a case consultation with Family Nurse Practitioner Robbie S. Lauter, MSN, RN-C, of evolving over a long period of time,” Holyoke Health Center. (HOANG ‘LEON’ NGUYEN / THE REPUBLICAN) she said. “BHN decided about ten years ago to focus its energies on how it could integrate services and care system, which has helped health,” Wilson said. “So we begin said BHN Vice President Jessica help people care for their whole BHN secure support and funding to wrap a team of people around DeFlumer-Trapp. The specialist to develop programs and services them to try and treat the whole indi- then conducts a brief evaluation and selves, long before most other agencies were thinking about that idea. that embrace a more effective and vidual rather than just one aspect of decides what course of action will So, we strategically began to identify worthwhile structure of health care, their health.” be most helpful in improving the Wilson said. Care teams involve staff members patient’s behavioral health, whether partners and work with primary care Under Wilson’s direction, BHN from both the primary care providit’s providing them with a referral to sites to see how we could do things has focused its efforts on impleer and from BHN, and can include one of BHN’s programs or supplying differently together.” menting the Triple Aim framework clinicians, recovery coaches, care them with community resources into its services. The agency has coordinators, nurses or medical asand self-therapeutic techniques. SEE PHYSICAL, PAGE D2