Integrating mental health care in primary care

October 2, 2017

Dr. Anna Ratzliff, associate director for Education for the AIMS Center
Behavioral health issues such as depression and anxiety are debilitating conditions and, unfortunately, common. But the integration of behavioral health and primary care services is proving successful in improving patient outcomes. The College is exploring such an integrated model of care for University Medical Center, which it operates. In September, the College hosted a group from the University of Washington AIMS Center, short for Advancing Integrated Mental Health Solutions, that presented its Collaborative Care model to College faculty and resident physicians who care for patients at UMC. “This is a way to improve access to mental health care,” said Dr. Tom Weida, UMC’s chief medical officer. “This is a great opportunity for folks who have mental health needs to get the care they need.” Collaborative Care treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Components of the AIMS model include: primary care providers and embedded behavioral health professionals; a behavioral care manager; a patient registry that allows providers to track patients and their response to treatment over time; the provision of medications and/or psychosocial treatments; and psychiatric consultation. “Collaborative care gives mental health care support to primary care physicians,” Dr. Anna Ratzliff, associate director for Education for the AIMS Center, said during the presentation at the College. “When you deliver collaborative care, it doubles the effectiveness of treatment. Collaborative care results in improved outcomes – less depression, less physical pain, better functioning and higher quality of life.” Ratzliff, also an associate professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington, said key to the AIMS Collaborative Care model is the oversight provided by a behavioral care manager, as well as the use of a patient registry and tracking. She said some health-care facilities “drop a mental health provider into a primary care setting, but without coordination, it might not be effective.” She also said the population health approach of the model – the patient registry and tracking – is important “because it makes sure patients don’t fall through the cracks and it’s a way to go out and actively engage them in care. Providers can also see who is improving and who isn’t, and tracking also helps patients see the progress they’re making, which is important when they feel stuck.” According to the AIMS Center, offering mental health care in primary care is convenient for patients, builds on existing provider-patient relationships and can help improve care for patients who have both medical and mental issues. “Collaborative care saves medical care costs and helps patients lead high-quality lives,” Ratzliff said.