Does It Work? PCBH Outcomes

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Presentation transcript:

Does It Work? PCBH Outcomes Jeff Reiter, phd, abpp

Scope for Today Goal: promote awareness of existing literature, discussion of gaps and issues Study selection PCBH-specific Outcome-specific Please let me know of omissions! Study quality: don’t shoot the messenger!

Clinical Outcomes PCBH Outcomes Patients receiving 2-4 visits show broad improvement in symptoms, functioning, well-being1-8 Effective for both mild and severe presentations More severely impaired may improve faster1 Changes are robust and stable at 2 years5 Patients report stronger connection to the BHC than to traditional, specialty therapists6

Systems Outcomes PCBH Outcomes Large reductions in specialty mental health referral rate9,10 Improved adherence to evidence-based guidelines10 More appropriate antidepressant prescribing9,10 Improved PCP willingness to engage with behavioral issues9,11 Improved detection of suicidal ideation12 High patient and PCP satisfaction9,11,13 More appropriate utilization of PCP4,10 Improved prevention (completion of anticipatory guidance in well-child checks)14

References Bryan, C. J., Corso, M. L., Corso, K. A., Morrow, C. E., Kanzler, K. et al. (2012). Severity of mental health impairment and trajectories of improvement in an integrated primary care clinic. Journal of Consulting and Clinical Psychology, 80(3), 396-403. Bryan, C.J., Morrow, C. & Kanzler, K. (2009). Impact of behavioral health consultant interventions on patient symptoms and functioning in an integrated family medicine clinic. Journal of Clinical Psychology, 65(3), 281-93. Cigrang, J. A., Dobmeyer, A. C., Becknell, M. E., Roa-Navarrete, R. A., Yerian, S. R. (2006). Evaluation of a collaborative mental health program in primary care: Effects on patient distress and health care utilization. Primary Care and Community Psychiatry, 11, 121-127. McFeature, B. & Pierce, T.W. (2011). Primary Care Behavioral Health consultation reduces depression levels among mood-disordered patients. Journal of Health Disparities Research and Practice, 5(2), 36-44. Ray-Sannerud, B. N., Dolan, D. C., Morrow, E. E., Corso, K. A., Kanzler, K. W., et al. (2012). Longitudinal outcomes after brief behavioral health intervention in an integrated primary care clinic. Families, Systems, & Health, 30(1), 60-71. Corso, K.A. Bryan, C.J., Corso, M.L, Kanzler, K.E., Houghton, D.C., Morrow, C.E. & Ray-Sannerud, B. (2012). Therapeutic alliance and treatment outcome in integrated primary care. Families, Systems, & Health, 30 (2), 87-100.

References Cigrang, J.A., Rauch, S.A., Avila, L.L., Bryan, C.J., Goodie, J.L., Hryshko-Mullen, A., Peterson, A.L., & STRONG STAR Consortium (2011). Treatment of Active-Duty Military with PTSD in Primary Care: Early Findings. Psychological Services, 8 (2), 104-113. Goodie, J., Isler, W., Hunter, C., & Peterson, A. (2009). Using behavioral health consultants to treat insomnia in primary care: A clinical case series. Journal of Clinical Psychology, 65, 294-304 Brawer, P.A., Martielli, R., Pye, P.L., Manwaring, J. & Tierney, A. (2010). St. Louis Initiative for Integrated Care Excellence (SLICE): Integrated-Collaborative care on a large scale model. Families, Systems & Health, 28(2), 175-187. Serrano, N. & Monden, K. (2011). The effect of behavioral health consultation on the care of depression by primary care clinicians. Wisconsin Medical Journal, 110 (3), 113-118. Torrence, N.D., Mueller, A.E., Ilem, A.A., Renn, B.N., DeSantis, B., & Segal, D.L. (2014). Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study. Families, Systems & Health, 32(4), 426-432. Bryan CJ, Corso KA, Rudd MD, Cordero L. Improving identification of suicidal patients in primary care through routine screening. Primary Care and Community Psychiatry. 2008; 13(4): 143-147.

References Angantyr, K., Rimner, A., Norden, T. & Norlander, T. (2015). Primary Care Behavioral Health model: Perspectives of outcome, client satisfaction, and gender. Social Behavior and Personality, 43(2), 287-302. Burt, J.D., Garbacz, S.A., Kupzyk, K.A., Frerichs, L., & Gathje, R. (2014). Examining the utility of behavioral health integration in well-child visits: Implications for rural settings. Families, Systems & Health, 32(1), 20-30.