As behavioral health needs surge across the U.S., healthcare systems are embedding services into primary and emergency care settings to improve access, reduce wait times and connect patients with appropriate mental health support.
Here are three systems and how they are integrating behavioral health:
1. Phoenix Children’s integration in the ED
Following the pandemic, Phoenix Children’s stationed psychiatric nurse practitioners in its emergency departments, allowing assessments and treatment — including medication — for children waiting for psychiatric services. At one time, there were nearly 24 children waiting for services, Funda Bachini, MD, division chief of psychiatry, told Becker’s.
“There are really long wait times in the community to see a psychiatrist, waiting on average six months, which is really hard,” she said. “If you’re at the point where you’ve reached out to a psychiatrist, you need help now, or else you wouldn’t be reaching out.”
The hospital also added mental health therapists so patients with psychiatric and mental health needs are seen within two hours of entering the department.
2. Baptist Health’s collaborative care model
With 270 primary care physicians, 61 offices and only 40 providers, about 50 therapists and 31 behavioral health offices, Jacksonville, Fla.-based Baptist Health turned to a collaborative care model. It saw significant gains, including a 30% decrease in behavioral health referrals.
“We have way too many people needing behavioral health services and not enough providers,” said Karen McNeely, DNP, APRN, the system’s APP service line chief and program director of its APP fellowship. “Access was clearly a problem.”
As behavioral health referrals began flooding in, a large volume was for low-acuity patients whose symptoms could be managed by a primary care physician, Ms. McNeely said. This shift opened specialists’ schedules to serve higher-acuity patients with more complex needs.
3. Magellan Health’s pediatric collaborative care model
Frisco, Texas-based Magellan Health launched a pediatric collaborative care model that enrolled nearly 8,000 patients, with 84% enrollment after assessment, and more than half stayed engaged through graduation. Forty percent of those graduates achieved clinically significant symptom reduction.
“The most important part about the collaborative care model is that it’s highly evidence-based, and it’s a proven model,” Magellan Health CEO Caroline Carney, MD, said. “It has been proven over and over again in research to increase quality of care, reduce cost of care and promote measurement-informed care.”
The model requires cultural change in clinics, she said. Once it is embedded, primary care providers become more confident asking about depression and suicidality because they are backed by a care manager and a consulting psychiatrist, she said.
