1. Jeff Capobianco National Council for Behavioral Healthcare University of Michigan

2. About the Center In partnership with Health & Human Services (HHS)/Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration (HRSA) and run by the National Council for Community Behavioral Healthcare Goal: To promote the planning, and development and of integration of primary and behavioral health care for those with serious mental illness and/or substance use disorders and physical health conditions, whether seen in specialty mental health or primary care safety net provider settings across the country. Purpose: To serve as a national training and technical assistance center on the bidirectional integration of primary and behavioral health care and related workforce development To provide technical assistance to PBHCI grantees and entities funded through HRSA to address the health care needs of individuals with mental illnesses, substance use and co-occurring disorders

3. 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

4. Addiction Professionals Addiction Professionals Training Curriculum Substance Use field will gain the understanding, knowledge and skills to build administrative and/or clinical relationships in order to provide SU services and supports in Primary Care settings. A “modularized” curriculum to train Substance Use professionals and/or administrative staff on how to provide services in primary care settings such as FQHCs and community health centers, emergency rooms, and other medical settings CME, CEU credits.

5. Social Workers Integrated Healthcare Curriculum for Schools of Social Work & Practicing Social Workers:  A competency-based curriculum to prepare graduate Social Work students for employment in an integrated setting.  Partially funded by the New York Community Trust & w/ collaboration from the Council on SW Education, curriculum offerings will be paired with funding for student integrated field placement opportunities.  For practicing social workers two online CE approved modules on IH Policy and Practice will be available in 2014.

6. Certificate in Integrated Behavioral Health and Primary Care

7. Beginnings For the University of Michigan School of Social Work to fund startup The capacity From a diverse advisory board of national leadership (e.g. SAMHSA), state leadership (e.g. MPCA), local clinicians, and University of Michigan scholars The interest For integrated health education and training beyond available options The need

8. The Program 1 Interactive web-based format 2 Continuing Education Credit (CE & CME) 3 Mix of live streaming lecture and small group videoconference

9. Details 40 hours of continuing education (Social Work CEU’s and Category 1 CME’s) Of the 40 hours, 32 are live streaming lectures with instant chat function for questions & comments Remaining 8 hours are self-paced pre-recorded lectures & web modules

10. Course Titles Integrated Behavioral Health and Primary Care in Context Medical Aspects of Behavioral Health Behavioral Aspects of Physical Health AssessmentInterventionConsultationCapstone Project

11. Skill Based Program is tailored for front-line cliniciansConcrete skills to bring to work But not neglecting broader policy context – “why we are doing this” Lectures paired with small group videoconferences to practice new skills and discuss new ideas

12. Capstone Project Participants are assigned to a cohort group & meet via video-conferencing. Capstone Projects are developed & executed with support/consultation from instructors & peers w/ the goal to move the student’s work or workplace in a more integrated direction. Examples of past Capstone Projects have included:  Introducing a screening tool for depression or tobacco addiction  Developing a new release of information form for routine use  Starting a new psychoeducational group. At the end of the program each participant shares their Capstone work with peers & the instructional team.

13. Who joined? Disciplines -Mainly MSW-level social workers (40+) -3-4 BSW’s -6-7 RN’s -2 physicians -1 psychologist -1 PhD-level evaluator Locations -Majority from Michigan -1 California -2 Ohio -4 Illinois Settings -Majority from Community Mental Health -Others from hospital systems, medical social work services, primary care clinics -Agencies sending multiple enrollees: University health system Area agency on ageing Community mental health Experiences and Roles -Front line clinical -Supervision and leadership -Program evaluation and administration -Wide range of early and late career professionals

14. Lessons Learned Even when asked to do so (repeatedly), participants will not test their computers in advance to make sure they work with our platforms. Therefore expect panic on day 1 when login problems inevitably emerge. After day 1, technological anxiety decreases and more learning takes place. Lecture content is only a small part of the program’s impact. Peer support and networking are critical. People are excited and passionate about integrated health!

15. Thanks…questions? Jeff Capobianco jeffc@thenationalcouncil.org 734.604.2591

16. The Following Slides are Additional Resources/Information about The Center for Integrated Health Solutions Workforce Training Initiatives. If you would like more information please do contact the center at www.integration.samhsa.gov

17. Consumer Training 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.

18. Psychiatrists Training 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

19. Primary Care Physicians Training 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

20. Case Managers in Behavioral Health Transforming traditional 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

21. Care Management in Primary Care Care management is central to the success of the Patient Centered Medical Home (PCMH) and to be successful, care managers working in primary care settings need to develop general skills at engaging patients promoting their activation to improve their own health general medical and behavioral health skills to be able to connect them to appropriate services Capacity to address questions, to teach healthy living, and support treatment plans.

22. Training for Community Members Mental Health First Aid (MHFA) Training Creating public capacity to identify, understand, & respond to signs of mental illnesses and substance use disorders. MHFA introduces participants to risk factors & warning signs of MH problems &/or S/A disorders, builds understanding of their impact, & common tx’s. CIHS is focusing its MHFA efforts on: Rural Communities Primary Care Providers Development of a Spanish Adaptation

23. The resources and information needed to successfully Integrate primary and behavioral health care