Tackling Challenges to the Integrated Health Workforce Kathleen Reynolds

It’s Not Just Us…. There is a Global Workforce Shortage The World Health Organization (WHO) estimates that 4.3 million more health workers are required to meet the need by 2015 Health workforce shortages have replaced system financing as “the most serious obstacle” to realizing the right to health within countries Source: Milbank Memorial Fund 2011 Report

Health Worker Shortage Too few health works being training and/or Too few health workers willing to work in the health system and/or Too few jobs for health workers

Workforce Disparities 24.3% of psychiatrists 5.3% of psychologists 14.9% of social workers 20% of counselors 8.5% of marriage and family therapists 4.9% of school psychologists 9.8% of psychiatric nurses Source: Presentation by Dr. Wesley Clark, 2011

National Health Service Corp What is It? A network of primary health care professionals that provide medical, dental, and mental and behavioral health services. In exchange for their service, the NHSC provides clinicians with financial support in the form of loan repayment and/or scholarship. NHSC clinicians fulfill their service requirement by working at NHSC-approved sites. Resource: Accessing the National Health Service Corp (NHSC); A Guide for Community Behavioral Health Providers and Primary Care Partners

Quick Tips: 5 Easy Steps Toward Joining the NHSC The below quick tips can help you begin the process of becoming an NHSC-approved site. Read CIHS’ new manual Understanding the National Health Service Corps to learn about the program and its application process.Understanding the National Health Service Corps Determine if you are located in a Health Professional Shortage Area (HPSA) by entering your address in HRSA’s HPSA Locator.HPSA Locator Contact your State Primary Care Office (PCO). Your PCO will walk you through the application process and answer any of your questions.State Primary Care Office Review the NHSC Service Site Reference Guide for details about what it means to be an NHSC site before you begin the application process.NHSC Service Site Reference Guide Apply online at the NHSC website (you must first created an online account). Apply online at the NHSC website

10 Ways States Can Respond  Career ladders for current workers  High schools oriented to health careers  Innovative, flexible educational programs  New and improved technologies, particularly information systems  More training programs for health careers  Increased education & training, including $ from Medicare & Medicaid  Evidence-based scope-of-practice requirements  Training for recent immigrants who were educated as health professionals in their native countries  Training of supervisors and managers  Expanded data collection and tracking of the supply, demand, and use of health workers Source: Workforce Issues Related to Physical and Behavioral Healthcare Integration Specifically Substance Use Disorders and Primary Care: A Framework

Workforce Challenges for Individuals Training and use of brief, focused assessments and interventions Facilitating client self-care management Credentialing Training and comfort working in diverse treatment settings (e.g. primary care)

CIHS Workforce Initiatives There is only on way to eat an elephant; one bite at a time

Consumers Whole Health Action Management (WHAM): This program creates workforce capacity by preparing consumers to serve as health educators and coaches. Guide participants through a person-centered planning process to set a whole health and resiliency goal and implementing a weekly action plan for success. The training is designed to support the emerging peer workforce to move into new health integration service models like health homes.

Psychiatrists Psychiatrist Training Curriculum: The 6 Module Psychiatrist Curriculums is designed to increase psychiatrists’ capacity to practice and/or consult in integrated health settings. Module 1: Introduction to Primary Care Consultation Psychiatry Module 2: Building a Collaborative Care Team Module 3: Psychiatrist Consulting in Primary Care Module 4: Behavioral Health in Primary Care Module 5: Medical Patients with Psychiatric Illness Module 6: The role of the Psychiatrist in the Public Mental Health System

Primary Care Physicians Primary Care Physician Training Curriculum: The Primary Care Curriculum is designed to create capacity for primary care physicians to treat and support individuals with a serious mental illness (SMI). Prevalence, SMI Characteristics, Pharmacological and Behavioral Interventions are highlighted. Module 1: Working with Patients with a Severe and Persistent Mental Illness; What should Primary Care Physicians Know? Module 2: Update on Psychopharmacology for Primary Care Physicians; Depression and Anxiety Part I & II

Case Managers Case to Care Managers Training: Transforming traditional mental health case management programs into assuming responsibility for the whole health of the individuals they serve. Topics include: Conceptual framework for change: health homes, chronic care model The physical health needs of people with behavioral health challenges Diabetes and heart disease: key issues and key interventions Exercises in motivational interviewing for health behavior change Self-assessment of individual practice

Social Workers Integrated Healthcare Curriculum for Schools of Social Works:  A competency-based curriculum and curriculum modules to prepare Masters of Social Work students for behavioral health practice focused on integrative and collaborative primary/behavioral health care.  Will prepare future MSWs to enter the workforce with the needed competencies to provide and lead integrated healthcare. Curriculum offerings will be paired with field placement opportunities committed to integration and collaboration.

Communities Mental Health First Aid (MHFA) Training Creating capacity within the public to identify, understand, and respond to signs of mental illnesses and substance use disorders. MHFA introduces participants to risk factors and warning signs of mental health problems and substance use disorders, builds understanding of their impact, and overviews common treatments. CIHS is focusing its MHFA efforts on: Rural Communities Primary Care Spanish Adaptation

The resources and information needed to successfully Integrate primary and behavioral health care Contact: Laura Galbreath, MPP Online: Phone: , ext Twitter: laura3530