Escalating prescription opioid use and abuse have emerged as major public health problems in Washington. Rural communities in particular have been hit hard due to their limited access to specialists. This project allows mental health specialists in urban areas to support health care providers in rural areas using videoconferencing technology. Patient evaluations and recommendations, caseload supervision, and education are all done remotely via telehealth. This project aims to establish acceptance, effectiveness, and cost-efficacy of telehealth for delivery of mental health and pain medicine care in rural primary care.
The Mental Health Integration Program (MHIP), supported and administered by the Community Health Plan of Washington in partnership with Public Health -Seattle and King County, integrates mental health screening and treatment in a collaborative care model (CoCM), including psychiatric case review and consultation. MHIP collaborative care teams in Washington State safety-net primary care settings serve diverse Medicaid and uninsured populations. Since MHIP’s inception in 2007, over 50,000 individuals have received integrated mental health services. In 2007 it began as a state-funded, two-county pilot for high risk uninsured adults in King and Pierce counties, but MHIP expanded statewide in early 2009 to include over 130 primary care clinics.
MHIP uses a patient registry (CMTS) to track and measure patient goals and clinical outcomes, and facilitate treatment adjustment if a patient is not improving as expected. MHIP also utilizes pay-for-performance mechanisms to support model fidelity and prioritize patient outcomes. Training and workforce efforts for this project focus on the whole team and all providers are trained on the fundamentals of CoCM.