Integrated Care

Question 1

What is the purpose of integrated care?

Answer 1

integration of behavioral health into behavioral medicine and biomedicine creating an integrated team-based health care delivery system

serves as a bridge between the medical and mental health worlds

Question 2

Who are the potential collaborators on an integrated care team?

Answer 2

social worker
marriage and family therapist
couselor
psychologist
psychiatrist
behavioral health consultant
child life specialist

others - dieticians, nurses, PT, etc.

Question 3

What are the three core components of integrated care?

Answer 3

1. biopsychosocial spiritual model
2. collaboration
3. Three world View

Question 4

What is the biopsychosocial spiritual model?

Answer 4

a model in which there is an understanding that all problems are at once biological, psychological and social

works from a systems model and encourages collaboration

Question 5

What are some biopsychosocial risk factors for treatment of medical patient?

Answer 5

depression, anxiety
family dysfunctin
substance abuse
poor coping skills
medication dependency
obesity and tobacco
unstable personality
exaggerated pain ratings
extended time off work

Question 6

What are some aspects that suggest a system is FULLY integrated?

Answer 6

1. one reception area
2. one treatment plan signed off by all
3. integrated funding with resources shared across needs
4. One board with equal representation from each partner
5. Evidence based practice
6. fully integrated electronic health record

Question 7

What are some differences in working styles/culture of primary care and mental health professionals that can hinder this?

Answer 7

1. different language
2. different traditional paradigm
3. different amount of time per session
4. use and culture around using medications
5. demand for services - around the clock vs scheduled sessions
6. somatic fixation in primary care vs psychosocial fixation with mental health

Question 8

What is disciplinary centrism?

Answer 8

you become educated in a particular model and you feel like it’s the best one - superior and more relevant

Question 9

What are the three world views?

Answer 9

clinical
operational
financial

Question 10

Why is integrating behavioral and physical care services a good idea?

Answer 10

1. mental health affects physical health
2. physical health affects mental health
3. stigma of behavioral health
4. comparmentalization of understanding of health
5. lessens cost

Question 11

Chronic medical conditions increases the likelihood of depression by what?

Answer 11

2-3 times

Question 12

What are some underlying ffactors explaining th elink between heart disease/anxiety/depression?

Answer 12

1. lack of self-care
2. sleep problems
3. obesity
4. blood vessel changes (free radicals and fatty acids)
5. stress

Question 13

What is the evidence that compromised emotional health leads to physical problems?

Answer 13

1. psychologically distressed patients experiences increased physical symptomology
2. 2/3 of primary care patients with a psychiatric dx have a significant physical illness
3. hippocampal atrophy in PTSD

Question 14

What are Galanti’s 4 Cs for culturally appropriate assessments?

Answer 14

What do you Call your problem
What do you think Caused the problem
How do you Cope with your condition
What Concerns do you have regarding your problems