1. Overview of Behavioral Health Consultant Services1

2. 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

3. 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

4. Why are Behavioral Issues such a Challenge for Primary Care?
3 c/o’s on average for 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

5. 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

6. 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

7. 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

8. 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

9. 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