Integrated Care Flashcards
Stages of chronic pain
- Injury
- Initial distress
- Exacerbation of psychological and social problems
- Acceptance of sick role
Integrated Care
integration of behavioral health into behavioral medicine and biomedicine creating integrated, team-based healthcare delivery system
- comprehensive and systemic interpretation
- bridges between medical and mental health worlds
Where are behavioral health consultants?
Inpatient care facilities Outpatient care facilities Research institutes Faculty of schools Private Practice Providers
Core components of integrated care
Biopyschosocial Spiritual Model (BPSS)
Collaboration -> mutual respect
Three world view -> clinician, administration, financial aspect
BPSS
all problems are at once biological, psychological, and social
- works from systems model and encourages collaboration
Collaboration
system of interaction that is created when health care providers, mental health care providers, and patients with their families work together over time to treat illnesses
- all participants play vital roles
- NEED FLEXIBILITY
Barriers to effective collaboration
Disciplinary centrism
Differences between disciplines
Lack of effective collaboration -> common goals not identified
Three World View
Clinical -> quality of care, patient driven
Financial -> reimbursement, coding, billing
Operational -> systems, organization, communication, process improvement
Why are they called worlds?
People are trained in ONE discipline
- speak different languages, ask different questions, seek different outcomes, employ different values/principles
If 1 world fails, all fail
All 3 worlds must work together
- clinical fails -> poor quality
- operationally fails -> poor service, disappointment, waste
- financially fails -> lose money, out of business
Why integrate the services?
- compromised physical health –> behavioral problems
- compromised behavioral health -> physical problems
- Stigma of behavioral services
- compartmentalized understanding of health
- Insurance/cost offset
Compromised physical health –> behavioral
chronic medical illness increases likelihood of depression 2 to 3 fold
Factors underlying link
- Lack of self-care
- Sleep problems
- Obesity
- Blood vessel changes
- Stress
Compromised behavioral –> physical
- psychologically distressed patients experience increased physical symptoms
- 2/3 of primary care patients with psychiatric diagnosis have significant physical illness
Stigma of behavioral services
- Majority of patients with significant symptoms of depression and anxiety seek treatment solely from primary care provider
- MUCH less likely to see a psychotherapist –> some even refuse referral
