Behavioral health integration is a priority for many health system leaders amid ever-tightening margins and persistent workforce shortages, but the way it plays out can vary across organizations. Teresa Lopez, director of behavioral health integration at Salt Lake City-based Huntsman Mental Health Institute, spoke with Becker’s about how the system’s concept of behavioral health integration has evolved from a provider-focused model to one centered on patient access and coordinated care.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: “Behavioral health integration” has different meanings. How does Huntsman define integration, and what were the strategic drivers that made it a priority?
Teresa Lopez: Every institution can define integration in a different way, and there’s no one-size-fits-all approach because of the way the systems function. We came to our integration model with Huntsman and the University of Utah Health because we saw a need for that same-day access to behavioral health support in the medical setting.
The original request came from the medical providers in primary care, because they were seeing patients with mental health symptoms that were coming into their primary care physicians, and just prescribing them an antidepressant and sending them on their way, which wouldn’t necessarily solve all of the issues. Sometimes there’s care coordination involved. Sometimes they need a little bit more time to process with someone on the spot.
When we originally integrated into the primary care setting, the direction we were given was to help the primary care providers — it was very provider-centric. That focus has shifted over the last 10 years to be more on access. We’re focused on some of the problems that we found with co-located care, and what that means is it’s more referral-based care, and it’s less coordination within the medical teams. We try to do a full integration model that includes population health-level management of mental health conditions across medical settings.
We use the collaborative care model, which is an evidence-based model, to deliver care to those who have an anxiety or depression diagnosis. We also use the Primary Care Behavioral Health model, which is a brief, same-day, and sometimes just a one-time, therapeutic visit when someone’s coming in to see their physician. Sometimes it’s a few episodes, but everything is tied back to the medical team that originated the relationship with the patient. We’re consulting with the primary care provider, our clinical pharmacy partners, and our care management partners who are in primary care, and really trying to deliver a team-based care model for any of our patients that come through.
We were trying to do a hybrid model in our medical settings, including the primary care, behavioral health model, and the collaborative care model, to address the population and then individual episodes of symptom acuity that come through primary care or the medical clinics.
