1. Integrated Behavioral Health: What Have You Tried? How Has It Worked? What Next? Kirk Strosahl Ph.D. Mountainview Consulting Group, Inc. E-mail: mountainconsult@msn.com Website: www.behavioral-health-integration.comwww.behavioral-health-integration.com

2. Webinar Objectives Appreciate the range of integration models and options Characterize what you have done thus far Assess successes and setbacks thus far Consider six domains of integration activity Conduct a self assessment of your integration program

3. The Continuum of Integration

4. Two Perspectives On Population- Based Care Horizontal Integration Panel Population Specialty Consultation Integrated Programs General Behavioral Health Consultation Vertical Integration Depression Clinical Pathway Chronic Depression Major Depression Dysthymia & Minor Depression Adjustment & stress reactions with depressive symptoms

5. 5 Dimensions of Integration Mission Clinical Service Physical Operational Information Financial

6. 6 Mission Integration The extent to which the behavioral and general medical service systems are pointing toward the same health objectives, goals and strategies – Rule: The goal is to improve the “health” of the entire population, not just to treat the sick

7. 7 Clinical service integration The degree to which general medical and behavioral providers seamlessly engage in assessment, intervention, and follow up activities – Rule: The more co-management processes, protocols and assessment tools, the better

8. 8 Physical integration The degree to which the general medical and behavioral health providers work in the same space, allowing for instantaneous access to care – Rule: Co-location is NOT the same as integration

9. 9 Operations integration The degree to which the general medical and behavioral health providers work off the same clinic “platform” – Rule: The more operations processes are shared (scheduling, reception, QI, support staff), the better

10. 10 Information integration The degree to which the general medical and behavioral health providers can access real time patient care information – Rule: Separate charts and sequestered information are the bane of our professions

11. 11 Financial integration The degree to which general medical and behavioral health services are funded as a “basic” form of health care – Rule: Integrative behavioral care should be financed as a “core” primary care service

12. 12 So...How integrated are we? General Rule: The more you have completely accomplished the six domains of integration, the more integrated you are! It’s that simple. Except that the “devil is in the details”!

13. Qualities of A Successful Integrated Behavioral Care Service Provides timely access for PCP Service is integrated within primary care setting Service is viewed as a form of primary care Service is provided in collaboration with the PCP Service is provided as part of the health care process

14. Qualities of a Successful Integrated Behavioral Health Care Service Goal is to increase impact of PCP team interventions Goal is to consult with and train the PCP to produce better outcomes Improved clinical outcomes, satisfied patients and health care providers, and managing productivity and financial risk are key targets