Effective bi directional integration evidence based best practices
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Effective Bi-Directional Integration: Evidence Based & Best Practices. Presented by: Kathleen Reynolds LMSW ACSW [email protected] Why bi-directional integration?. Persons with serious and persistent mental illness die, on average at the age of 53 .

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Effective Bi-Directional Integration: Evidence Based & Best Practices

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Effective bi directional integration evidence based best practices

Effective Bi-Directional Integration: Evidence Based & Best Practices

Presented by:

Kathleen Reynolds LMSW ACSW

[email protected]


Why bi directional integration

Why bi-directional integration?


Persons with serious and persistent mental illness die on average at the age of 53

Persons with serious and persistent mental illness die, on average at the age of 53

  • Higher Rates of Modifiable Risk Factors:

    • Smoking

    • Alcohol consumption

    • Poor nutrition / obesity

    • Lack of exercise

    • “Unsafe” sexual behavior

    • IV drug use

    • Residence in group care facilities and homeless shelters

Vulnerability due to higher rates of:

  • Homelessness

  • Victimization / trauma

  • Unemployment

  • Poverty

  • Incarceration

  • Social isolation


Model of bi directional integration

Model of Bi-Directional Integration


Models bi directional integration

Models – Bi-Directional Integration

Behavioral Health –Disease Specific

  • IMPACT

  • RWJ

  • MacArthur Foundation

  • Diamond Project

  • Hogg Foundation for Mental Health

  • Primary Behavioral Healthcare Integration Grantees

    Behavioral Health - Systemic Approaches

  • Cherokee Health System

  • Washtenaw Community Health Organization

  • American Association of Pediatrics - Toolkit

  • Collaborative Health Care Association

  • Health Navigator Training

Physical Health

  • TEAMcare

  • Diabetes (American Diabetes Assoc)

  • Heart Disease

  • Integrated Behavioral Health Project – California – FQHCs Integration

  • Maine Health Access Foundation – FQHC/CMHC Partnerships

  • Virginia Healthcare Foundation – Pharmacy Management

  • PCARE – Care Management

    Consumer Involvement

  • HARP – Stanford

  • Health and Wellness Screening – New Jersey (Peggy Swarbrick)

  • Peer Support (Larry Fricks)


What do we know about what works

What do we know about what works?

  • Three strategies have been identified in a meta-analysis of successful integration programs

    • A consulting psychiatrist

    • A primary care provider prescribing all meds

    • Care coordination (Gilbody, 2006)


Additional implementation strategies for bi directional integration

Additional Implementation Strategies for Bi-directional Integration

  • Partnerships between behavioral health and primary care or “do it yourself”

  • Financing: Maximize existing billing options to fund integrated care

  • Staffing: PhD, LMSW, LPC, BSW, Consumers

  • Electronic Medical Records

  • Registries

  • Bridging the professional culture gap


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