Integrated Health/Behavioral Health Competencies in SMH Melissa George MHEDIC May 2015

Today Background Comprehensive health in SMH Integration of care across/within service delivery settings Examples of integrated approaches Workforce Competencies for Integrated Care Measuring workforce competencies Assessing SMH clinicians’ competencies Advancing training for integrated service provision Feedback on measure/approach

Comprehensive Health in SMH Key to quality and evidence-based practice in school mental health is addressing comprehensive health needs We’ve been developing integrated strategies for providers to use as part of existing practices SMH clinicians teaching youth & families to apply behavioral strategies to healthy lifestyles promotion Conducted promising pilot study Clinicians identified they needed more training on integrated health promotion

Integration of Health/Behavioral Health Federal agencies prioritizing integrated care to Reduce disparities in access to care Address needs of the “whole” person Identify/intervene early Integration across/within service delivery settings Improve coordination of care Colocation of services Integrated care by provider Primary Care Behavioral Health

Current Integrated Care Approaches National Center for SMH & National Association for School Nurses SAMHSA & HRSA’s Center for Integrated Health Solutions Training for Health Providers in Schools System Level Models of Integrated Care Resources Screening Tools Decision Making tools Screening Tools Workforce Competencies

Current Integrated Care Approaches National Center for SMH & National Association for School Nurses SAMHSA & HRSA’s Center for Integrated Health Solutions Training for Health Providers in Schools System Level Models of Integrated Care Resources Screening Tools Decision Making tools Screening Tools Workforce Competencies Workforce Competencies

Workforce Competencies in Integrated Care No set of competencies for either behavioral health or primary care workforce Identified competencies for integrated practice for providers Key informant interviews Literature reviews Review of existing competency sets Competencies should not be provider-specific (not separate ones for health & mental health) Annapolis Coalition on the Behavioral Health Workforce

Integrated Competency Areas A. INTERPERSONAL COMMUNICATION (9) Establish rapport quickly and communicate effectively with consumers of healthcare, their family members and other providers. B. COLLABORATION & TEAMWORK (18) Function effectively as a member of an interprofessional team that includes behavioral health and primary care providers, consumers and family members. C. SCREENING & ASSESSMENT (11) Conduct brief, evidence-based and developmentally appropriate screening and to conduct or arrange for more detailed assessments when indicated. D. CARE PLANNING & CARE COORDINATION (11) Create and implement integrated care plans, ensuring access to an array of linked services, and the exchange of information among consumers, family members, and providers. E. INTERVENTION (18) Provide a range of brief, focused prevention, treatment and recovery services, as well as longer-term treatment and support for consumers with persistent illnesses. F. CULTURAL COMPETENCE & ADAPTATION (6) Provide services that are relevant to the culture of the consumer and their family. G. SYSTEMS ORIENTED PRACTICE (6) Function effectively within organizational and financial structures of the local system of healthcare. H. PRACTICE-BASED LEARNING & QUALITY IMPROVEMENT (11) Assess and continually improve services delivered as an individual provider and as a team. I. INFORMATICS (6) Use information technology to support and improve integrated healthcare.

Integrated Competencies of SMH Clinicians SMH clinicians teaching youth & families to apply behavioral strategies to healthy lifestyles promotion CLIMB training currently includes Evidence-Based Practice Family Engagement & Empowerment Quality Assessment and Improvement CLIMB Curriculum Clinicians said they need more training on integrated health How can we use the Integrated Health/ Behavioral Health Competencies for providers to assess current competencies and identify training needs?

Integrated Competencies of SMH Clinicians Adapt Competencies into a Measure (see handout) Survey national sample of SMH clinicians to assess their “integrated health/behavioral health” competencies? Compare in relation to demographic characteristics, training, experience, setting, population, EPBAS, etc. Do a “cross-walk” with other competency sets E.G., Professional competencies involved in expanded SMH (Ball, Anderson-Butcher, Mellin & Green, 2010)

Questions Reactions to Integrated Health/Behavioral Health Competencies as a Measure ? Competencies capture “ability” what about current practice? Similar to other competency sets that focus on interprofessional or interdisciplinary teaming Language modified? Less health care jargon? Capture CLIMB training specific competencies? Suggestions for other work needed prior to or instead of that will inform training for clinicians to deliver integrated health promotion as part of SMH?

Cross-Walk with ESMH Competencies Professional competencies involved in expanded SMH (Ball, Anderson-Butcher, Mellin & Green, 2010) Key policies & Laws Interprofessional Collaboration Cross-Systems Collaboration Provision of Academic, Socio-emotional, and Behavioral Learning Supports Data-Driven Decision-Making Personal and Professional Growth and Well-being Cultural Competence