Addressing Behavioral Health Needs - Integration into Primary Care Setting

Addressing Behavioral Health Needs - Integration into Primary Care Setting

At a time when many organizations are just beginning to explore new opportunities to enhance behavioral health services, UnityPoint Health has been taking the lead. The additional focus on these types of services is important, as according to the National Institute of Mental Health, roughly 20 percent of Americans are impacted by mental health.

UnityPoint Health Behavioral Services

The alignment and coordination for behavioral health services across all UnityPoint Health facilities and communities is no easy task. Some may call it daunting. David Deopere, Ph.D., Vice President, Development of Behavioral Health at UnityPoint Health, calls it the right thing to do.

“In major health systems, behavioral health services typically were discussed in terms of an inpatient psychiatric setting,” Dr. Deopere said. “Today, it’s not just about inpatient and partial hospitalization services. While we certainly acknowledge the inpatient need will always be there, it is now about finding the right treatment, for the right people, at the right time.”

For the past 44 years, Dr. Deopere has held leadership roles in the mental health field, including serving as the President of the Robert Young Center for Community Mental Health in the Quad Cities. Since 2014, Dr. Deopere has been developing a plan for how behavioral health services and access to those services can be advanced within UnityPoint Health.

An early aspect of this work included categorizing behavioral health services on a scale of “least- restrictive” to “most-restrictive” services, allowing the UnityPoint Health behavioral team to further identify ways of making access to behavioral health care as easy as possible for patients.

“Least-restrictive services include home-based or school-based services, where we are able to meet patients exactly where they are. More-restrictive services include services where patients need to be within our facilities for a certain period of time. We use metrics to assess what services on this scale are best for patients, and we’ll continue to pursue these metrics and find ways to treat patients in the least-restrictive manner to achieve the best outcomes,” Dr. Deopere said.

Dr. Deopere has identified a number of Core Behavioral Health Services that should be provided at UnityPoint Health, as related to population health management. These were identified as being correlated with reduction in emergency department visits, medical inpatient admissions and readmissions, as well as reducing utilization of primary care visits. These services include:

  1. Embedding of behavioral health therapists in UnityPoint Clinic primary care clinics.
  2. Screening for co-morbid behavioral disorders in UnityPoint Health emergency departments and UnityPoint Clinic locations.
  3. Improving access in hospital emergency departments for behavioral patients.

These incorporate behavioral health components into care coordination and targeted case management, along with the overall UnityPoint Health model of care.

As mentioned, UnityPoint Health is striving to lessen emergency room visits and hospitalizations by integrating behavioral health services in the primary care clinic setting.

“We know 40-70 percent of all visits to primary care clinics present co-morbid behavioral disorders along with presenting health complaints, such as heart disease, cancer, diabetes, hypertension, obesity and others. It is critical to develop a system-wide model in conjunction with our outpatient entities,” Dr. Deopere said.

Work has already begun throughout the system to clinically integrate behavioral health within UnityPoint Clinic locations. Thus far, UnityPoint Health has far exceeded expectations by embedding 42 embedded behavioral therapists in its regions, with the goal of increasing that number further by the end of 2016.

Number of PC Clinics with Embedded Behavioral Consultants (by region)

Region PCMH 2.0 Clinic UPC/Trimark
Uno UPC Clinic
Non-UPC Clinic Telehealth TOTAL
Cedar Rapids 1 2 0 0 3
Central Iowa 2 3 0 0 5
Dubuque 0 0 0 0 0
Fort Dodge 1 3 1 3 8
Madison 0 0 2 0 2
Peoria 0 5 0 0 5
Quad Cities 1 10 4 0 15
Quincy 0 0 3 0 3
Sioux City 0 0 0 0 0
Waterloo 1 0 0 0 1
TOTAL 6 23 10 3 42

“Studies show patients are more likely to seek or follow through with behavioral health visits if the services are easily accessible to them. Once implemented in outpatient settings, our behavioral therapists will work hand-in-hand with patients, helping them understand their illnesses, make action plans, prepare them for possible relapses and assist to make their medical care plan truly patient-centered,” Dr. Deopere said.

Dr. Deopere is confident UnityPoint Health can continue to positively impact the way behavioral health services are offered through changes such as these.

“We are committed to furthering behavioral services as a whole through enhancing resources and access. In the next several years, I believe we’ll see great change in our behavioral programming.”

Find a UnityPoint Health Behavioral Services Provider

If you or a family member has questions related to behavioral health services or needs to seek treatment, contact your UnityPoint Health primary care provider.

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