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Integrated Care

Working at the Interface of Primary Care and Behavioral Health

Edited by Lori E. Raney, M.D.

  • ISBN 978-1-58562-480-5
  • Item #62480

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Description

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.

Contents

  • Contributors
  • Foreword
  • Preface
  • Acknowledgments
  • Section I: Behavioral Health in Primary Care Settings
  • Chapter 1. Evidence Base and Core Principles
  • Chapter 2. The Collaborative Care Team in Action
  • Chapter 3. Role of the Consulting Psychiatrist
  • Chapter 4. Child and Adolescent Psychiatry in Integrated Settings
  • Chapter 5. Risk Management and Liability Issues in Integrated Care
  • Chapter 6. Training Psychiatrists for Integrated Care
  • Section II: Primary Care in Behavioral Health Settings
  • Chapter 7. The Case for Primary Care in Public Mental Health Settings
  • Chapter 8. Providing Primary Care in Behavioral Health Settings
  • Chapter 9. Behavioral Health Homes
  • Chapter 10. Management of Leading Risk Factors for Cardiovascular Disease
  • Index

Contributors

    D. Anton Bland, M.D.
    Lydia Chwastiak, M.D., M.P.H.
    Benjamin G. Druss, M.D., M.P.H.
    Robert Hilt, M.D.
    Wayne Katon, M.D.
    John S. Kern, M.D.
    Kristen Lambert, J.D., M.S.W., LICSW, FASHRM
    Gina Lasky, Ph.D.
    Joseph Parks, M.D.
    Marcella Pascualy, M.D.
    Lori Raney, M.D.
    Anna H. Ratzliff, M.D., Ph.D.
    Barry Sarvet, M.D.
    Clare Scott, LCSW
    Jurgen Unutzer, M.D., M.P.H., M.A.
    Erik R. Vanderlip, M.D., M.P.H.
    Martha C. Ward, M.D.

About the Authors

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.

During the next decade, typified by health reform implementation, psychiatrists will assume a new and important role by contributing to the health of outpatients with comorbid behavioral (mental health and chemical dependence) and physical health disorders. Integrated Care, edited by Dr. Raney, consolidates thoughts by integrated care experts on topics that allow transition from traditional outpatient psychiatric practice to collaborative care with medical colleagues in both primary care and specialty behavioral health settings. It is a must-read for psychiatric trainees and for early and mid-career psychiatrists since it will allow them to be in the vanguard of behavioral health professionals that improve care, health, and cost as a part of a more efficient and effective health care delivery system.—Roger Kathol, M.D., President, Cartesian Solutions, Adjunct Professor, Departments of Psychiatry and Internal Medicine, University of MN


Integrated Care is a much needed comprehensive review of essential psychiatric practice in the context of 21st century health reform. By providing models of collaborative mental health care in primary care settings and primary care in mental health settings, this volume addresses the clinical realities and public health imperatives of recognizing and treating co-morbid psychiatric and general medical illness. Psychiatric trainees, early career psychiatrists and everyone in the mental health field will find this of immense value.—Steven S. Sharfstein, M.D., President and CEO, Sheppard Pratt


What comes to mind is the Rosetta Stone. That single ancient rock is remembered today because of its value in translating and sorting out a variety of languages. With Integrated Care: Working at the Interface of Primary Care and Behavioral Health Lori Raney has skillfully brought together the multiple languages and vast experience with integrated care, and put it into one very useful document that is both scholarly and extremely practical. I have personally been involved with the design and execution of over three different integrated care projects here at Johns Hopkins. This book is going to become mandatory read for all our project staff. It is a great asset to the field. Thank you Lori and all for assembling such a valuable group of authors to provide such a valuable book.—Anita Everett MD, DFAFA, Division Director Community and General Psychiatry, Johns Hopkins Bayview Medical Center


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.—James R. Rundell, M.D., Department of Psychiatry, Veterans Administration Medical Center, Minneapolis, MN


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.—Howard H. Goldman, M.D., PhD, Professor of Psychiatry, U Maryland School of Medicine, Baltimore, MD


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.—Philip R. Muskin, M.D., Professor of Psychiatry at CUMC, Chief of Service: Consultation-Liaison Psychiatry, New York-Presbyterian Hospital/Columbia Univ. Medical Center


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.—Paul Summergrad, M.D., Dr. Frances S. Arkin Professor and Chairman, Department of Psychiatry, Professor of Medicine, Tufts University School of Medicine; Psychiatrist-in-Chief, Tufts Medical Center


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.—Richard F. Summers, M.D., Clinical Professor of Psychiatry, Co-Director of Residency Training, Perelman School of Medicine of the University of Pennsylvania, Past-President, American Association of Directors of Psychiatry Residency Training, Chair, Council on Medical Education and Lifelong Learning, American Psychiatric Association


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.—Herbert Pardes, M.D., Executive Vice Chairman of the Board of Trustees, New York-Presbyterian


This book will be of huge value to psychiatrists, primary care physicians, and clinical staff of all disciplines; administrators; and state government officials. Most of all, it will benefit those who need our care so desperately and do not have adequate access.—Marie Hobart, M.D., Psychiatric Services, 11/01/2014


Integrated Care: Working at the Interface of Primary and Behavioral Health, a new book from American Psychiatric Publishing, brings together two sides of the interface—with hands-on, how-to advice for psychiatrists serving as consultants to primary care as well as working to improve the health status of patients with serious mental illness in community mental health centers.—Mark Moran, Psychiatric News, 01/26/2015


This excellent, very practical book reads as though you're sitting in an APA symposium Each chapter has a unique voice and something special to offer. All in all, whether you're enthusiastic about practicing integrated care or reluctant lifting your head out of the sand wondering what's coming to a health home near you, this book is worth a read.—Mark Ragins, M.D., American Journal of Psychiatry, 10/15/2014


If you are a psychiatrist or behavioral health professional involved with designing, implementing, or being hired to work within an integrated care model, buy and read this book! It provides well referenced, practical information on integrated care programs.—Anita S. Everett, M.D., DFAPA, Section Director, Community Psychiatry, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center Baltimore, MD, Journal of Psychiatric Practice Vol. 22, No. 2, 03/01/2016

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