The health system’s Center for Neurological Restoration treats movement disorders, including Parkinson’s Disease and Huntington’s Disease. Taylor Rush, PhD, is the director of behavioral services and interdisciplinary programs at the center.
Dr. Rush joined as the center’s first psychologist around a decade ago. Since then, the center has added several more mental health professionals, she said. The center is working to expand its behavioral health efforts and support the mental health needs of caregivers for those with movement disorders.
Dr. Rush sat down with Becker’s to explain her approach to integrating behavioral and specialty neurological care.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How is treatment for movement disorders evolving, particularly from a psychological perspective?
Dr. Taylor Rush: [Movement disorders] are chronic neurologic conditions that have a significant physical component, but we’re recognizing and appreciating the emotional component of what it is to manage a condition like this day to day. For many individuals, it may change how they are able to function in everyday life. It may change expectations as far as what they can do in their role at work or with family. It can affect relationships, and a sense of self and identity. All of these dimensions are ones we tend to address when we meet with patients for their care.
Q: What are the benefits of integrating and co-locating psychological care for movement disorders?
TR: I started as the first psychologist in our center almost 10 years ago. At that time there was a lot of education that went into informing our neurology colleagues about what psychology is and what role we play. I did a lot of hard work to get them on board and bought in. Now, they come to expect psychology as part of a patient’s care. I think we’ve really introduced a culture where mental health is valued in the same way as physical health.
Over time, we’ve been able to grow our team. We now have three psychologists, two psychiatrists, a psychiatry physician assistant and two social workers. We’ve really been able to show our value and therefore increase our bandwidth in order to provide the best care for our patients.
What’s really nice is we all work next to each other. In my office, I have two neurologists on either side of me. It’s easy to do curbside consults with them to discuss patient care. We have patient management meetings where we discuss patients and the kinds of needs they have. We can easily communicate across the medical record we share, and we can see each other’s notes, which helps tremendously as we’re trying to make sure people receive even care. The right hand knows what the left hand is doing.
Q: What evolutions are you watching in the movement-disorder space?
TR: One thing that has evolved, even over the past few years as a product of the pandemic, has been the amount of virtual care we provide. Prior to the pandemic, when in-person was really the only viable option for most, I don’t think we had nearly the reach we do now. Up to 60% to 70% of the care that we deliver is virtual, which means that our reach has expanded throughout all the corners of Ohio, as well as throughout the U.S. We’ve been able to ensure that patients that otherwise wouldn’t have received the speciality care we offer have been able to receive it.
I foresee that continuing to be the case, and we want to provide more options for virtual care, including group options. Even though our team has grown exponentially, the need continues to grow at a pace we can’t always keep up with. Sometimes we encounter longer waits than we would like, where patients may have to wait up to two or three months before they can get in to see us. So we want to streamline some parts of our care to include group-based care so we can make sure that more patients can be seen, [and] can be offered the right types of support and specialty care they deserve in a much more timely manner.
One area I’m really focusing on this year is to improve and enhance the options for our care partners — especially for those with Parkinson’s Disease — because the amount of resources out there for them right now is rather sparse and can be intermittent. We want to make sure that our care partners are receiving equal care to their loved ones in our center, because we want to be comprehensive and make sure everyone is supportive.
Q: What advice do you have for hospitals and health systems looking to achieve better integration between behavioral health and specialty care?
TR: There’s been a lot of mental health integration in primary care, where there’s co-location, curbside consults, there are models that help ensure patients are getting real-time care in ways that they need. I think we’re a little bit behind in specialty care practices.
The biggest thing is to see how co-located care can be created, and make sure that members of a mental health team are integrated and interfacing with their medical providers on the team. Once there is that team mentality, once there is that connection and sense of shared responsibility of managing treatment plans and patient care, it makes a huge difference — and patients see that.
