Montana healthcare professionals met this week to discuss how to support a person’s physical and mental health in the midst of reduced services.
Aaron Wernham is a family physician and CEO of the Montana Healthcare Foundation. He says the idea of bringing behavioral health care providers into primary care practices in Montana started about 10 years ago.
“When you walk into the clinic and check in, most of us are used to either filling out a written questionnaire or having the nurse while she’s checking your vital signs maybe ask you some questions about how your health is doing. One of the things that’s happening at that first part of the visit is we’re adding some questions," he says.
Wernham says these added questions about symptoms of depression, anxiety and addictions aim to treat the whole person. It’s a strategy many of the 300 attendees at the Integrated Behavioral Health Summit in Bozeman use to improve patient care and reduce costs.
Wernham says if it seems like the best way to address those issues is that day, the health care provider will walk with the patient down the hall to meet with a behavioral health care provider.
“You just don’t want patients to have to go through more work when they’ve got a lot going on," he says. "So if you can come in for a visit, maybe it’s for a sore throat, but you’re also feeling a little sad or you need some extra help with alcohol use or whatever it may be, right on that same day, you get care.”
Wernham says trying to schedule another appointment, figuring out transportation or taking time off from work can make it harder for people to get the help they need. He says the other piece of making integrated care a success is through coordination of providers with a shared database.
One of the biggest challenges, he says, is the shortage of people who can provide mental health care services, especially in rural areas rocked by recent closures following funding cuts from Montana's special 2017 legislative session.
Big Horn Valley Health Center is working to address this by partnering with the tribal community college in Lame Deer to create local training for behavioral health care providers.
“IBH is really getting traction," says Sheila Hogan, director of the Montana Department of Public Health and Human Services. "It’s now implemented to some degree in all of the federally-qualified health centers, the majority of the hospitals, and you are working very hard every day to make that happen.”