Integrating Behavioral Health and Primary Care

Description

• Current and new models of integrated care
• Pathways to care for major psychiatric disorders
• Brief treatments in integrated care environments
• Useful to anyone working or want to work in these new integrated care environments

Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. 

We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems 
We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s). 

Table of Contents

Contents
Foreword by Robert Freedman
Foreword by Paul Summergrad
Preface
Acknowledgments
Personal Acknowledgments (Robert E. Feinstein MD)
Personal Acknowledgments (Joseph V. Connelly, MD)
Personal Acknowledgments (Marilyn S. Feinstein, ACC, LCSW, USPTA)
Part I: Models of Integrated Care
Chapter 1: Conceptual Framework for Integrated Care: Multiple Models to Achieve Integrated Aims
Alexis A. Giese and Maryann Waugh
Chapter 2: Integrated Healthcare at Cherokee Health Systems
Parinda Khatri, Greg Perry, and Frank deGruy
Chapter 3: Canadian Approach to Integrated Care
Nick Kates and Ellen Anderson
Chapter 4: Team-Based Integrated Primary Care
Tziporah Rosenberg, Colleen T. Fogarty, Michael R. Privitera, and Susan H. McDaniel
Chapter 5: The Patient-Centered Medical Home
Colleen Conry, Shandra Brown Levy, and Bonnie T. Jortberg
Chapter 6: Financing Integrated Care Models
Bruce Schwartz, Gillian Stein, and Scott Wetzler
Chapter 7: Integrating Physical and Mental Health Care in the Veterans Health Administration: A Path to the Future
Lisa V. Rubenstein
Chapter 8: Aging Brain Care: A Model of Integrated Care for Dementia and Depression
Catherine A. Alder, Mary Guerriero Austrom, Michael A. LaMantia, and Malaz A. Boustani
Chapter 9: Telehealth in an Integrated Care Environment
Maryann Waugh, Debbie Voyles, James H. Shore, L. Charolette Lippolis, and Corey Lyon
Chapter 10: Automated Mental Health Assessment for Integrated Care: The Quick PsychoDiagnostics (QPD Panel) Panel Meets Real-World Clinical Needs
Jonathan Shedler
Part II: Integrative Care for Psychiatry and Primary Care
Chapter 11: Integrated Care for Anxiety Disorders
Robert D. Davies, Isabelle Guillemet, and Adam Trosterman
Chapter 12: Treating Depression and Bipolar Disorder in Integrated Care Settings
Christopher Schneck
Chapter 13: The Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Integrated Primary Care
Elizabeth Lowdermilk, Nicole Joseph, and Robert Feinstein
Chapter 14: Integrating the Treatment of Substance Use Disorders into Primary Care Settings
Patricia Pade, Sophie Collins, and Laura Martin
Chapter 15: Integrated Care For Binge Eating Disorder And Other Eating Disorders
Joel Yager, Philip S. Mehler, Eileen D. Yager, and Alison R. Yager
Chapter 16: Somatic Symptom Disorders and Illness Anxiety in Integrated Care Settings
Alla Landa, Marina Makous, and Brian A. Fallon
Chapter 17: Personality Disorders In An Integrated Care Setting
Robert E. Feinstein and Joseph V. Connelly
Chapter 18: Violence and Suicide
Robert E. Feinstein
Part III: Integrated Care for Medical Sub-Specialties and Behavioral Medicine in Primary Care
Chapter 19: Non-Epileptic Seizures: Integrative Care Model for Neurology and Psychiatry
Lynn Fenton, Brian Rothberg, Laura Strom, Allison M. Heru, and Mesha-Gay Brown
Chapter 20: Women's Mental Health Across The Reproductive Lifespan
Noa Heiman, Abby Snavely, and Liza Freehling
Chapter 21: Assessing and Treating Sexual Problems In An Integrated Care Environment
Kenneth M. Pollock and Alan M. Altman
Chapter 22: Wellness: An Integrated Care Approach
Meegan Lipman, Jacqueline Calderone, Joel Yager, and Maryann Waugh
Chapter 23: Integrated Chronic Pain and Psychiatric Management
Robert M. McCarron, Amir Ramezani, Ian Koebner, Samir J. Sheth, and Jessica Palka
Chapter 24: Death and Dying: Integrated Teams
Anne A. Brewer and Joseph V. Connelly
Part IV: Psychosocial Treatments in Primary Care and Medical Specialty Clinics
Chapter 25: Health Coaching in Integrated Care
Marilyn S. Feinstein, and Robert E. Feinstein
Chapter 26: Crisis Intervention in Integrated Care
Scott Simpson and Robert E. Feinstein
Chapter 27: Best Practice for Family-Centered Health Care: A Three-Step Model
Joanna Sturhahn Stratton, Katherine Buck, and Allison M. Heru
Chapter 28: Group Interventions in Integrated Care Settings
Brian Rothberg and Hillary D. Lum

Author Information

Edited by Dr. Robert Feinstein, Professor of Psychiatry and Vice Chair, The University of Colorado School of Medicine, Edited by Dr. Joseph Connelly, Assistant Clinical Professor of Medicine, Columbia University, and Edited by Dr. Marilyn Feinstein, Licensed Clinical Social Worker

Robert E. Feinstein, M.D., is Professor of Psychiatry at the University of Colorado School of Medicine and a Psychoanalyst. He is Vice Chairman of Clinical Affairs and Education formerly serving as Senior Associate Dean in the medical school In his academic career, Dr. Feinstein has had diverse and sustained focus on Integrated/Primary Care, Violence and Suicide prevention, health and wellness, personality disorders, and the psychotherapies.

Joseph V. Connelly MD is chairman of the Department of Family Medicine at Stamford Hospital. He is also on the faculty at the Stamford Hospital/Columbia University Family Medicine Residency Program where he served as Program Director for the past 27 years. He has special interests in behavioral medicine and palliative medicine.

Contributors:

Abby Snavely, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Adam Trosterman, MD
Department of Medicine
Division of Internal Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Alan M. Altman, MD
Department of Obstetrics, Gynecology, and Reproductive Biology
Harvard Medical School
Boston, MA
International Society for the Study of Women's Sexual Health
Lakeville, MN

Alexis A. Giese, MD
Departments of Psychiatry and Family Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Alison R. Yager, MD
Aurora Centrepoint
Kaiser-Permanente
Aurora, CO

Alla Landa, PhD
Department of Psychiatry
Columbia University Medical Center
New York, NY

Allison M. Heru, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Amir Ramezani, PhD
Department of Anesthisology and Pain Medicine
University of California, Davis School of Medicine
Sacramento, CA

Anne A. Brewer, MD, MPH
Palliative Care Service
Stamford Hospital
Stamford, CT

Bonnie T. Jortberg, PhD, RD, CDE
Department of Family Medicine
University of Colorado Denver
Denver, CO

Brian A. Fallon, MD, MPH, Med
Department of Psychiatry
Columbia University Medical Center
New York, NY

Brian Rothberg, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Bruce Schwartz, MD
Department of Psychiatry & Behavioral Sciences
Montefiore Medical Center
Bronx, NY

Catherine A. Alder, JD, MSW, LSW
Aging Brain Care
Eskenazi Health Senior Care
Indianapolis, IN

Colleen Conry, MD
University of Colorado Denver
Denver, CO

Colleen T. Fogarty, MD, MSc
Department of Family Medicine
University of Rochester School of Medicine & Dentistry 
Rochester, NY

Corey Lyon, DO, FAAP
AF Williams Family Medicine
Family Medicine Residency Program
University of Colorado
Aurora, CO

Cristopher Schneck, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Helen and Arthur E. Johnson Depression Center
Behavioral Health Directory
University of Colorado Hospital HIV Clinic
Aurora, CO

Debbie Voyles, MBA, HOM
Access Care Telehealth
Colorado Access
Denver, CO

Eileen D. Yager, MD
Department of Pediatrics
University of Colorado, Denver School of Medicine
Integrated Pain and Symptom Management Clinic
Children's Hospital Colorado
Aurora, CO

Elizabeth Lowdermilk, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Ellen Anderson, MD, MHSC, MCFP
Clinical Assistant Professor
Department of Family Medicine
University of British Columbia
Sooke, British Columbia

Frank deGruy, MD
Department of Family Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Gillian Stein
Montefiore Medical Center
Bronx, NY

Greg Perry, MD
Psychiatric Services
Cherokee Health Systems
Knoxville, TN

Hillary D. Lum, MD, PhD
Division of Geriatric Medicine
Department of Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Ian Koebner, MSc,MAOM, L.Ac
Department of Anesthesiology and Pain Medicine
University of California, Davis School of Medicine
Sacramento, CA

Isabelle Guillemet, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Jacqueline Calderone, MD
Departments of Psychiatry and Family Medicine
University of Colorado, Denver School of Medicine
AF Williams Family Medical Center
Helen and Arthur E. Johnson Depression Center
University of Colorado Anschutz Medical Campus
Aurora, CO

James H. Shore, MD, MPH
Depression Center Helen and Arthur E. Johnson
University of Colorado Anschutz Medical Campus
Aurora, CO

Jessica Palka, BS
Department of Psychiatry and Behavioral Sciences
University of California, Davis School of Medicine
Sacramento, CA

Joanna Sturhahn Stratton, PhD, LMFT, Licensed Psychologist
Division of Counseling and Family Therapy
Regis University
Denver, CO
University of Colorado, Denver School of Medicine
Aurora, CO

Joel Yager, MD, FAED
Department of Psychiatry
University of Colorado, Denver School of Medicine
Department of Psychiatry and Biobehavioral Sciences
David Geffen School of Medicine
University of California at Los Angeles
Department of Behavioral Sciences
University of New Mexico School of Medicine

Jonathan Shedler, PhD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Denver, CO

Katherine Buck, PhD, LMFT
John Peter Smith Family Medicine Residency
Fort Worth, Texas

Kenneth M. Pollock, PhD
Department of Psychiatry
New York Medical College
Valhalla, NY

L. Charolette Lippolis, DO, MPH
Colorado Access
AccessCare
Denver, CO

Laura Martin, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Laura Strom, MD
Department of Neurology
University of Colorado, Denver School of Medicine
Aurora, CO

Lisa V. Rubenstein, MD, MSPH
VA Greater Los Angeles
UCLA David Geffen School of Medicine
UCLA Jonathan and Karin Fielding School of Public Health
RAND Corporation
North Hills, CA

Liza Freehling, WHNP-BC
Generations ObGyn
Aurora, CO

Lynn Fenton, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Malaz A. Boustani, MD, MPH
Indiana University Center for Aging Research
Center for Health Innovation and Implementation Science
Indiana University School of Medicine
Regenstrief Institute, Inc.
Indianapolis, IN

Marina Makous, MD
Department of Medicine
Columbia University Medical Center
New York, NY

Mary Guerriero Austrom, PhD
Department of Psychiatry
Indiana Alzheimer Disease Center
Indiana University Center for Aging Research
Indiana University School of Medicine
Indianapolis, IN

Maryann Waugh, MEd
University of Colorado, Denver School of Medicine
University of Colorado Anschutz Medical Campus
Colorado Access
Aurora, CO

Meegan Lipman, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Mesha-Gay Brown, MD
Department of Neurology
University of Colorado, Denver School of Medicine
Aurora, CO

Michael A. LaMantia, MD, MPH
Indiana University Center for Aging Research
Indiana University School of Medicine
Regenstrief Institute, Inc.
Indianapolis, IN

Michael R. Privitera, MS, MD
Department of Psychiatry
University of Rochester School of Medicine & Dentistry 
Rochester, NY

Nick Kates, MB.BS, FRCPC, MCFP(hon)
Department of Psychiatry and Behavioural Neurosciences
Michael G. DeGroote School of Medicine
McMaster University
Hamilton, Ontario

Nicole Joseph, MD
Department of Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Noa Heiman, PhD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Parinda Khatri, PhD
Cherokee Health Systems
Knoxville, TN

Patricia Pade, MD
Department of Family Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Philip S. Mehler, MD, FACP, FAED
Department of Medicine
University of Colorado, Denver School of Medicine
Eating Recovery Center
Denver Health Medical Center
Denver, CO

Robert D. Davies, MD
Department of Psychiatry
University of Colorado, Denver School of Medicine
Aurora, CO

Robert M. McCarron, DO
Department of Anesthesiology and Pain Medicine
Department of Psychiatry and Behavioral Sciences
University of California, Davis School of Medicine
Sacramento, CA

Samir J. Sheth, MD
Department of Anesthesiology and Pain Medicine
University of California, Davis School of Medicine
Sacramento, CA

Scott Simpson, MD, MPH
Department of Psychiatry
University of Colorado, Denver School of Medicine
Denver Health Medical Center
Denver, CO

Scott Wetzler, PhD
Department of Psychiatry and Behavioral Sciences
Montefiore Medical Center
Bronx, NY

Shandra Brown Levy, PhD
Department of Family Medicine
University of Colorado Denver 
Denver, CO

Sophie Collins, MD
Department of Family Medicine
University of Colorado, Denver School of Medicine
Aurora, CO

Susan H. McDaniel, PhD
Departments of Psychiatry and Family Medicine
University of Rochester School of Medicine & Dentistry
Rochester, NY

Tziporah Rosenberg, PhD, LMFT
Departments of Psychiatry and Family Medicine
University of Rochester School of Medicine & Dentistry
Rochester, NY