Key Lessons from Spearheading Behavioral Health Integration in Modern Primary Care
Since entering the behavioral health field in the early 2000s, I’ve had the distinct pleasure of witnessing the power of quality services and their ability to influence positive change on an individual, family, and systems level. From treating patients in my private practice to serving as Vice President of Quality and Excellence at Open Hearts Family Wellness in Phoenix, I’m forever proud of the impact I’ve made — both big and small — so people can lead happier, healthier lives. Naturally, as I’m sure many clinicians do, I’m always wondering how we as healthcare professionals can do more to drive change at a higher level.
That’s why I joined evolvedMD, a national leader in behavioral health integration in modern primary care, nearly five years ago. In fact, I was their first employee, working as a Behavioral Health Manager (master’s level clinicians at the center of our enhanced collaborative care model). I then got promoted to clinical supervisor, overseeing the day-to-days of several Behavioral Health Managers. Now, I serve on its executive team as Director of Clinical Services, where I lead and support a team of engaging and effective providers to ultimately deliver critical behavioral health services to practices nationwide.
Today, I’d like to share the lessons I’ve learned in spearheading behavioral health integration in modern primary care since joining evolvedMD.
1. Establish the mission of integration from the get-go
Prior to me joining evolvedMD in 2017, evolvedMD’s co-founders Steve Biljan and Erik Osland piloted and tested integrated medication management on the chronically ill at a primary care site in Phoenix — an idea inspired by Erik’s personal experience with his own chronically ill father.
With previous experience in the broken medical system, Steve and Erik knew that something had to be done and that the solution could also be commercially viable. What they didn’t expect however was what evolvedMD’s pilot uncovered — two important points that compelled me to join: 1) there was a large group of the population screening positive for depression, and 2) these people had little to no access to care. This harrowing realization prompted them to tackle the mental health crisis and adapt evolvedMD’s model to include a licensed social worker who can treat mental illness.
This is where my journey with evolvedMD began.
From the beginning, I wanted to ensure we were not just better than other behavioral health providers, but different, radically different. Together, we worked to enhance the Psychiatric Collaborative Care (CoCM) model to be more comprehensive and to focus on supporting our frontline clinicians. It was through this process we developed our unique approach to collaborative care that is embedded, in person, comprehensive, and overall, beyond collaborative, to ultimately reduce stigma, increase access, and drive better patient outcomes.
2. Fortify your staff’s health and well-being for improved patient outcomes
Last year, Erik published a great piece proving that good culture drives good business. Understanding that taking care of our people means ultimately providing the best experience for everyone in our ecosystem, we have been intentional about focusing on our people above anything else. As a tenured behavioral health organization, we are uniquely positioned to understand how burnout, chronic stress, and other adverse mental health symptoms — common among clinicians — can have major consequences. If our people are personally struggling, they can’t do what they do best: providing meaningful interventions for the people we serve. Simply put: if our people aren’t taking care of themselves, they can’t take care of others.
How do we encourage wellness and incentivize our people to take care of themselves?
We promote self-care, nurture personal and professional development, demand a work-life balance (we limit our clinicians’ caseloads so they can strictly adhere to an 8–5, Monday through Friday schedule), engage in the communities we operate in, and regularly celebrate wins. In doing so, our clinicians are better able to deliver excellent service to our patients and increase patient satisfaction with overall care.
Even more impactful — our executive team actively models all the above, which is especially important at a time when only 40% of employees believe their employers care about their mental health.
3. Champion DEI initiatives for both employees and patients
Since our founding, our rapid growth will see us delivering more than 50,000 sessions annually, increasing access to critical services for underserved populations. While certainly something to celebrate, we also recognize that minority populations have long faced barriers to accessing the same high-quality care. We work hard to promote Diversity, Equity, and Inclusion initiatives to build a more impactful culture at evolvedMD, but we also want to be mindful that we’re making a similar impact on the communities we serve. This is critical as racial/ethnic, gender, and sexual minorities often suffer from poor mental health outcomes due to inaccessibility of high-quality mental health care services. By embedding our clinicians onsite and in person at primary care practices, these minoritized communities can see a therapist in the same building as their PCP and get much-needed help.
4. Be proactive in bridging the gaps in care delivery and the development of whole-patient care
Familiar with the harrowing state of mental health in America that is unfortunately hitting my home state of Arizona hardest as we rank 49th for prevalence with lack of access, it’s my personal passion to trailblaze a new path for mental health.
From counseling patients to coaching BHMs as a clinical supervisor to scaling critical behavioral health services nationwide as Director of Clinical Services, I’ve seen first-hand how our enhanced collaborative care model plays a significant role in revolutionizing this path.
Unfortunately, traditional behavioral health and primary care are failing us all. With little information sharing or collaboration to treat a patient holistically, the current system can, at worst, be often reactive, only treating patients when symptoms become severe. With our enhanced collaborative care model, integrating behavioral health with primary care enables us to streamline communication, identify adverse symptoms earlier, and connect patients with services right away so that symptoms are less likely to become severe, resulting in improved outcomes for patients.
Ultimately, our enhanced collaborative care model enables us to marry mental and physical health and truly treat the whole body, the whole patient, the whole person.
5. Add commercialization and economic viability from a clinician’s perspective
If you’re a leader at an early-stage company, proving economic viability is difficult no matter the industry. However, I’m proud to say that evolvedMD has successfully created, launched, and implemented a model that is both clinically validated and economically viable.
Our greatest testament to commercializing behavioral health integration is making HonorHealth, one of the largest medical groups in Arizona and the US, the first fully integrated primary group in Arizona by:
· Enhancing the traditional collaborative care model
· Embedding our clinicians within HonorHealth’s collaborative teams
· Balancing clinician self-care with manageable case loads
· Reducing attrition rates that are historically high in traditional behavioral health systems
With proven success at scaling commercially, evolvedMD is set to provide integrated behavioral health services to more than 100 practices engaging more than 500 primary care providers in Arizona and Utah by the end of 2022.
What can clinics do to deliver better care to patients?
If you’re a primary care provider or a healthcare professional looking to drive improved patient outcomes, the solution is simple: integrate.
Due to the inability to access traditional behavioral health services, patients often rely on primary care providers as their singular point for mental health services with 60% of patients with behavioral health problems treated solely in primary care making you the de facto mental health solution.
For primary care practices, this offers the unique opportunity to help current and future patients by focusing on whole-body care through integrated behavioral health with evolvedMD.
A market leader in integrated behavioral health, evolvedMD is the preferred solution for practices across Arizona committed to the whole patient. By partnering with evolvedMD, your practice becomes a comprehensive solution for the full spectrum of physical and behavioral health services as patients are better served when primary care and behavioral health work together.
I hope that this piece has provided some context on how to do integration right and that my reflections and recommendations serve you and your patients well in the future.
Learn more about our unique and upfront approach to delivering better results for your patients.
