The leaders of Montefiore Medical Center's Care Management Organization and its Bronx Behavioral Health Integration Program in New York discuss how psychiatry plays a critical role in leading the way in health care reform.
In the News
Andrew Pomerantz, MD, one of the pioneers of integrated care, describes the evolution of integrated care in the Veterans Health Administration (VA) and discusses how it can be applied to health care in general.
In his column, Jürgen Unützer, MD, MPH, MA discusses a stepped care approach to integrating behavioral health care into primary care. He describes the multi-tiered approach, which provides increasing levels of behavioral health specialist involvement when a patient is not improving as expected.
Historically viewed as a specialist-treated illness, bipolar disorder is increasingly being treated in primary care and psychiatric consultants on Collaborative Care teams are being asked to advise and assist on treatment. Joseph Cerimele, MD, MPH discusses the treatment of bipolar disorder in primary care settings.
The American Psychiatric Association (APA) received a four-year, $2.9 million grant to train psychiatrists in integrated care. In collaboration with the AIMS Center, the APA will train 3,500 psychiatrists in the skills needed to support the implementation of Collaborative Care in primary care practice settings.
A new article by Anna Ratzliff, MD, PhD used stakeholder input to develop practical approaches to integrating behavioral health care in to primary care settings. Two resources were created for achieving integrated care: 1) The Behavioral Health Integration Implementation Guide, which includes practical guidance on both the implementation process and sustanability, and 2) the GROW Pathway Planning Tool, which helps an organization develop a path toward integration.
Katharine Bradley, MD, MPH, Evette Ludman, PhD, and Ryan Caldeiro, MD, summarize the research that is informing new care models for alcohol use disorders. Repeated medical interventions have shown to be effective, however primary care providers can also play an important role in the recovery of patients with Alcohol Use Disorder. This includes helping the patient choose an appropriate treatment option and providing support throughout their recovery.
Mark Sullivan, MD, PhD discusses the need for including psychiatric care in the treatment of chronic pain. This column focuses on the increase in opioid therapy to treat chronic pain, which can result in opiod misuse or abuse in patients with psychiatric disorders. Additionally, studies have suggested that chronic pain and common mental disorders are intimately linked. Through this evidence, Dr. Sullivan calls for an integration of psychiatrists into the primary care team to better adress both the mental and physical needs of chronic care patients.
A new study published in Psychiatric Services highlights the importance of early follow up in depression care. The study found that patients who received a follow up contact four weeks after their initial assessment had shorter times to improvement than those who did not.
Jürgen Unützer, MD, MPH, MA discusses some promising approaches for improving the reach and effectiveness of integrated behavioral health care. Dr. Unützer's column focuses on two approaches: 1) the systematic involvement of family members, peers, community health workers, and community-based organizations in care, and 2) the use of technology in care.