Integrated Care: Working at the Interface of Primary Care and Behavioral Health

Integrated Care: Working at the Interface of Primary Care and Behavioral Health

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Overview

Integrated Care: Working at the Interface of Primary Care and Behavioral Health by Lori E. Raney

The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward.

The book's features are both high-impact and user-friendly: • The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment.• Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting.• Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience.• Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship.

The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.

Product Details

ISBN-13: 9781585624805
Publisher: American Psychiatric Publishing, Incorporated
Publication date: 10/03/2014
Pages: 300
Product dimensions: 5.90(w) x 8.90(h) x 0.80(d)
Age Range: 18 Years

About the Author

Lori E. Raney, M.D., is the Medical Director of Axis Health System in Durango, Colorado, and owner of Collaborative Care Consulting in Dolores, Colorado.

Table of Contents

ContributorsForeword PrefaceAcknowledgmentsSection I: Behavioral Health in Primary Care SettingsChapter 1. Evidence Base and Core Principles Chapter 2. The Collaborative Care Team in ActionChapter 3. Role of the Consulting PsychiatristChapter 4. Child and Adolescent Psychiatry in Integrated Settings Chapter 5. Risk Management and Liability Issues in Integrated CareChapter 6. Training Psychiatrists for Integrated CareSection II: Primary Care in Behavioral Health SettingsChapter 7. The Case for Primary Care in Public Mental Health SettingsChapter 8. Providing Primary Care in Behavioral Health SettingsChapter 9. Behavioral Health HomesChapter 10. Management of Leading Risk Factors for Cardiovascular DiseaseIndex

What People are Saying About This

John Sargent

Integrated Care: Working at the Interface of Primary Care and Behavioral Health is an excellent and timely book. Its depiction of team based care, roles for Behavioral Health Professionals, Primary Care Physicians and Psychiatrists and changes necessary for training and practice is comprehensive and impressive. The book contains an outstanding chapter on integration in Pediatrics and child mental health. If you believe that integrated care is best for our patients and our practice as I do, this book will help you transform your care of your patients.

George Rust

Teamwork is essential for us to treat patients as whole people, with heart and mind, body and soul, all connected. This book provides a strong evidence-base for the bidirectional integration of primary care and behavioral health in a collaborative care model, with practical strategies for implementing these models and for training a new generation of professionals to practice psychiatry as a team sport in the 21st century.

Hunter L. McQuistion

Dr. Raney and her colleagues have been able to distill technique and evidential knowledge into a highly practical, eminently readable, as well as clearly groundbreaking book that assists clinicians and administrators as they move into psychiatry's future. It will be read, read again, and then again, as an essential guide to plan, implement, and practice in collaborative care settings. Primary care providers will also find Integrated Care very helpful as they themselves orient their own work in new collaborative contexts.

Alexander Blount

This book is much needed. It introduces a crucial member of the team, the consulting psychiatrist, to the collaborative care process in integrated primary care. It does a first rate job of introducing psychiatrists to both the routines of practice and to the spirit of multi-disciplinary team work on which the success of primary care behavioral health integration depends.

Alexander Blount, EdD, Director, Center for Integrated Primary Care, Professor of Family Medicine and Psychiatry, Univer - Alexander Blount

This book is much needed. It introduces a crucial member of the team, the consulting psychiatrist, to the collaborative care process in integrated primary care. It does a first rate job of introducing psychiatrists to both the routines of practice and to the spirit of multi-disciplinary team work on which the success of primary care behavioral health integration depends.

Richard F. Summers, M.D., Clinical Professor of Psychiatry, Co-Director of Residency Training, Perelman School of Medici - Richard F. Summers

Lori Raney's edited volume is the answer to the question we are all asking -- how do we effectively integrate psychiatric practice with primary care? The experts in this book describe a critical new role for psychiatrists, show us the data, describe the core principles, and detail the new attitudes, skills and behaviors needed to collaborate effectively with primary care providers. This will be an essential resource for the next generation of residents and other psychiatrists ready to step into the future.

Ruth Shim

With the advent of health care reform, collaborative care is fast becoming an extremely important mental health service delivery model. Psychiatrists must have a seat at the table in developing and implementing integrated care models across a variety of health care settings. Integrated Care: Working at the Interface of Primary Care and Behavioral Health is prerequisite reading for any psychiatrist hoping to make a significant contribution to the discussion and practice of integrated care.

Joan Kenerson King

In the rapidly changing world of health care this book provides a road map in a critical area of need, the role of the psychiatrists and other prescribers in these integrated systems of care. Dr. Raney and her colleagues represent the leaders in this transforming part of medicine and this book is must reading for anyone leading these emerging systems of care. It covers the full continuum of integration and is an essential guide for practice and also potential research directions.

Howard H. Goldman

Integrated Care is a well-edited, authoritative resource for clinicians working at the interface of primary care and behavioral health. Lori Raney, an acknowledged expert in integrated care, has edited chapters from an outstanding array of the leading voices in the field, who present the evidence for integrated care and provide guidance for psychiatric practice in general medical settings. The book is an essential tool for psychiatrists who wish to expand their practice opportunities in the future.

Richard F. Summers

Lori Raney's edited volume is the answer to the question we are all asking -- how do we effectively integrate psychiatric practice with primary care? The experts in this book describe a critical new role for psychiatrists, show us the data, describe the core principles, and detail the new attitudes, skills and behaviors needed to collaborate effectively with primary care providers. This will be an essential resource for the next generation of residents and other psychiatrists ready to step into the future.

John Santopietro

Integrated Care: Working at the Interface of Primary Care and Behavioral Health is sure to be a bedrock resource in what is one of the most rapidly growing and integral aspects of healthcare today. It is clear that our current 'dis-integrated' healthcare system is broken, driving us bankrupt, and leaves millions to suffer with untreated mental illness. There is no viable path forward without integration. Regardless of where you live in the healthcare ecosystem. Dr. Raney leverages her proven track record of 'on the ground' system transformation and calls on her friends - who also happen to be the best of the best - to assemble a map that points the way forward and shows us all how to catch up. This book is a must-have for leaders, administrators and clinicians alike.

Philip R. Muskin

Integrated care is no longer a research subject, waiting for data to support its use. In this book, written by an all-star group of authors, Dr. Raney has assembled a guide to operationalizing a new way for psychiatrists to function in both primary and behavioral health care settings. The Affordable Care Act has the potential to provide care to many people who now have no such access. That goal will require we learn how to integrate care and collaborate with our colleagues in a variety of settings. This book is required reading for those who will participate in 21st century psychiatry.

M.D. Paul Summergrad

Lori Raney has produced an outstanding guide to providing comprehensive medical and psychiatric care in primary care and in community psychiatric settings. As experienced clinicians, she and her collaborators have produced a text that will prove helpful to practitioners and trainees alike.

Deborah S. Cowley

This valuable and well-written book provides a comprehensive overview of integrated care, including both integration of behavioral health into primary care and of medical care into settings serving the chronically and seriously mentally ill. Chapters address overall "big picture" public health and policy issues, the unmet health care needs met by integrated care, the practical nuts and bolts of working as a psychiatrist in integrated care settings, important legal and liability issues, key issues for workforce development, and ways in which educational experiences in integrated care address ACGME competencies and Psychiatry milestones. This volume, with its clear and easy-to-read description of the background and rationale for integrated care, as well as its specific case examples, guidelines, tables, and resources will be very helpful to any clinician, educator, or health care administrator interested in establishing, working in, or educating young psychiatrists for this novel type of practice.

Frank Verloin deGruy III

Bravo! Raney and her coauthors have written a brilliant book about psychiatrists practicing collaboratively with primary care clinicians to bring integrated, whole person care to the people of this nation. Here psychiatrists can find the best thinking and evidence about why this is important, what this kind of care looks like in practice, how to do it, and how to train for it. This is a beautiful and important piece of work that I will be recommending to my primary care and psychiatrist colleagues alike.

Eliot Sorel

Dr. Lori Raney's, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is an invaluable and catalytic tool for psychiatric physicians, primary care colleagues and the collaborative primary care/behavioral health team to seize the opportunities stimulated by the Affordable Care Act and the evolving new models of populations' health and team based care. It is well grounded on Dr. Raney's, hands on clinical experience with primary care/behavioral health collaboration in the state of Colorado and it offers a clear, concise and pragmatic path for its adoption and implementation in other settings. I highly recommend it to all interested in better navigating and engaging in the evolving American health system.

Jules M. Ranz

As a psychiatrist who has spent most of his career training public psychiatrists, I found the chapter on Training Psychiatrists for Integrated Care particularly informative. The authors emphasize that psychiatrists working in integrated career need to focus on indirect care with much of the communication occurring via telephone, tele-video or electronic forms such as e-mail, text and electronic medical records. The approach utilizes population-based care and measurement-based treatment with regular use of screening instruments: depending on electronic data bases to track key clinical and quality of care outcomes of a specific population of patients to determine which patients need "step up" care; 'ruling-out' high risk conditions and trusting the team to initiate a preliminary treatment plan even in the absence of a 'perfect' diagnosis; delivering brief behavioral interventions that have been proven effective in primary care settings, such as motivational interviewing, behavioral activation, problem solving therapy, and health behavior change intervention such as smoking cessation.

Herbert Pardes

Health reform represents great potential for changes in the delivery of health care. Integrated care as one component is a developing theme embracing increasing segments of mental health care/general health. It can improve treatment of patients with various mixtures of mental health/substance abuse and non-behavioral health care. There is considerable evidence pointing to improved outcomes due to integrated care. Its value is being increasingly accepted and implemented in care systems around the country.

Dr. Raney has done a superb job dealing with the array of issues ranging from mechanisms of delivery to education and development of an adequate workforce to questions of liability.

For all interested in the broad sweep of mental health care and its evolution in conjunction with health reform, this superb text brings comprehensive information and helps signal a dramatic movement in the history of mental health care.

Paul Summergrad

Lori Raney has produced an outstanding guide to providing comprehensive medical and psychiatric care in primary care and in community psychiatric settings. As experienced clinicians, she and her collaborators have produced a text that will prove helpful to practitioners and trainees alike.

James R. Rundell

Dr. Raney has assembled the best available talent from a wide array of disciplines to build the definitive text of integrated behavioral health, with particular relevance to the roles and contributions of psychiatrists. From the first page to the last it is clear that her level of expertise and experience informs a practical yet thoroughly scientific treatment of this ever-evolving model of practice. The liberal use of graphics and case examples brings to life the unique skills and capabilities necessary for optimal implementation of integrated behavioral health care in the primary care setting. This text is a remarkable achievement that will become the standard referral resource for clinicians in new and established integrated behavioral health programs.

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