Overview of Behavioral Health Consultant Services 1

Why I’m Here: Primary Care is our “de facto MH system”: Full spectrum of psych disorders Children, adults, older adults Chronic as well as acute problems Somatic complaints HA, IBS, chronic pain, insomnia Sub-threshold problems Marital problems, DV, bereavement, occupational problems, parenting 2

The de facto MH system (cont’d) Lifestyle counseling (prevention) Smoking, ETOH, exercise, diet Chronic disease management Fastest growing part of primary care Coping, self-mgmt, family education Only half comply w/ self-mgmt regimen 3

Why are Behavioral Issues such a Challenge for Primary Care? 3 c/o’s on average for 10-15 min visit PCM reluctant to ask (Pandora’s Box) Patients don’t report (focus on physical sx) Stigma re psych care Lack of insurance for psych care Long waitlists for psych care 4

Patients I Can Help With Adults, Children, Individuals, Families Any pt with a significant behavioral component to his/her problem Includes medical problems w/ behavioral component (tobacco cessation; wt mgmt; psychophysiological d/o; insomnia; tx nonadherence, etc.) 5

The Consultative Model: What I’ll do with your patients CONSULTATION You are primary customer Brief, problem-focused 20-mins; minimal f/u Focus on small chg or treatment planning Simple interventions Education; referral; easily supported plans PSYCHOTHERAPY Patient is primary customer Broad focus, long-term 50-min; open-ended Usu. large changes Complex, multiple Psych care separate from other health care 6

The Consultative Model (cont’d) Help w/ complicated assessments, phone calls, crises, visit-sharing for high-utilizers Re-referral is always appropriate You will get written and/or verbal recommendations for each referral Consult probably NOT appropriate for: Specific medication questions 7

How to Refer to BHC Refer to BHC as “consultant”, “team member” Express that you’d like assistance helping pt with ______ problem Find a problem the pt is concerned about “Warm handoff” is ideal (okay to interrupt); important to see same day Minimal (or no) paperwork! 8

In Sum… I’m here to help you better assist your pts with their behavioral issues I am open to ANY behaviorally-based issue Please utilize same-day, warm-handoff referrals for every pt, if possible I look forward to working with you! 9