Collaborative Care Stories
The AIMS Center is most widely known for its work in spreading the Collaborative Care Model (CoCM) but many of the practices we work with incorporate CoCM into a “blended” or stepped model that combines other behavioral health interventions and strategies. Blended models of care seen in successful integrated care practices frequently combine CoCM and the Primary Care Behavioral Health (PCBH) Model, also known as the Behavioral Health Consultant Model.
Measurement-based care (MBC) is a framework in which validated symptom rating scales and screening tools are routinely used in clinical practice to inform treatment decisions and adjustments. The most widely used tool in MBC is the Patient Health Questionnaire nine-item scale (PHQ-9).
A new book, Integrated Care: Creating Effective Mental and Primary Health Care Teams, provides the first comprehensive guide for teams to integrating effective mental health care into primary care clinics. Edited by a team of UW Medicine mental health experts, it includes practical information, skills, and clinical approaches needed to implement Collaborative Care, an evidence-based model of integrated care developed at the University of Washington. Importantly, it provides a common resource and framework for all members of the care team including care managers, psychiatrists, primary care providers, and administrators.
Only months after opening, the UW Neighborhood Ravenna Clinic in Seattle, Washington began offering Collaborative Care to its patients as part of the Behavioral Health Integration Program (BHIP). A young, vibrant care team was recruited to support the effort, including the hiring of Dr. Crystal Wong as Clinic Chief.
Trauma comes in many different forms and is much more prevalent than people think. Statistics vary, but the consensus is that fifty to ninety percent of adults and children are exposed to at least one psychologically traumatic event at some point in their lives. Many types of trauma increase the risk of health, social and emotional problems, and there is a direct link between childhood trauma and adult onset of chronic disease, including depression.
One of the most promising approaches to further improve the reach and effectiveness of behavioral health care is the systematic involvement of family members, peers, community health workers, and community-based organizations.
Although there is growing sentiment that strengthening behavioral health care services in primary care is critically needed, the majority of existing behavioral interventions were developed for settings very different from the fast paced environment of primary care.
Angel Mathis, ARNP was the primary care provider (PCP) featured in Daniel’s Story, a video chronicling a young man named Daniel and his journey with depression. Angel worked with a Collaborative Care team to deliver Daniel’s depression care at County Doctor, a community health center in the Mental Health Integration Program.
Implementing effective mental health services in primary care is hard. The AIMS Center has witnessed this repeatedly through our work helping clinics implement Collaborative Care, a chronic care model adapted for mental health. In our experience, clinics committed to measurement-based mental health care find solutions to the inevitable challenges inherent in practice change, but some clinics falter along the way. Examining why yields useful lessons that future clinics can use to improve their chances of success.