Wayne Young, Chair of the AHA's Section for Psychiatric and Substance Abuse Services, on How Hospitals Can Integrate Behavioral and Physical Health
Hospitals and health systems across the country are addressing the behavioral health needs of their patients and communities. While historically, behavioral health may not have been top of mind, hospitals understand that behavioral and physical health are inseparable. Through behavioral health services, community partnerships and advocacy, hospitals are helping to ensure people suffering from psychiatric and substance abuse issues get the care they need.
We asked Wayne Young, senior vice president, behavioral health, at JPS Health Network in Fort Worth, Texas, and chair of the AHA’s Section for Psychiatric and Substance Abuse Services, to offer recommendations for hospitals and health systems as they work to integrate physical and behavioral health. Young had the following advice:
1.) Every hospital and health system should think about partners in their community. There are plenty of resources and these groups are more than willing to be partners. It’s sometimes hard for community not-for-profits to know how to access the hospital – there’s no “front door” except the ER. It can be hard to know who in a hospital to reach out to, who’s doing this kind of community and partnership building. Local organizations want to help their communities as much as the hospital or health system does. Don’t assume you’re starting at zero. Use the resources already available in your community.
2.) Don’t try to boil the ocean. Simply addressing “behavioral health” can be overwhelming. That means you need to be strategic. What is one issue that keeps you up at night and how do you address it? For example, I just had a meeting about behavioral health patients that interact with law enforcement due to lack of treatment – and that’s one tiny sliver of behavioral health but it can have a huge impact if addressed well.
3.) Don’t limit thinking to traditional roles and treatment models. Traditionally, behavioral health outpatient care was seen as the guy with the pipe and the patient on the couch – but it’s not like that anymore. Since there’s a shortage of beds and providers in many areas, be creative when it comes to your workforce. Use teams of people. For example, if behavioral health care patients are over-using the ER, then use peer counselors who can become navigators to connect patients with community resources. Peer counselors have lived experiences that could be more valuable to behavioral health patients in crisis than those with traditional clinical skills; this allows for brief interventions instead of solely medically oriented treatment. Being creative can mean being more effective with less resources.
4.) No matter what, integrate behavioral health services into your care system wherever you’re at in this journey. One example is screening patients for depression during a primary care visit to identify issues before more intensive and costly care is needed. Embedding behavioral health specialists into primary care can reduce stigma and dramatically improve access to care. When behavioral health services become part of the normal course of care, it can improve patient experience and treatment by keeping patients from traveling from provider to provider.
The bottom line: All hospitals have a mission to improve the health of their communities. We know there’s no health without mental health. We cannot ignore the impact of untreated or undertreated serious mental illness. Wherever you’re at on your journey to integrating behavioral and physical health, I hope these tips will help you on your way.