E-Merge Program: Integrated Behavioral Health
In 2002, the Center teamed with the City of Austin’s Community
Health Centers (CHC) to install counseling services within the CHC
clinics and created the Merge Program. It was quickly evident that
the traditional approach of psychotherapy could not keep up with
the overwhelming demand for mental health services. In 2003, with
additional funding from the Hogg Foundation for Mental Health, the
Center and CHC have decided on an entirely new approach to providing
mental/behavioral health to CHC patients. This cutting edge model
is Integrated Behavioral Health (IBH). The new E-Merge program integrates
Behavioral Health Consultants (BHC) into the clinic’s medical
team. It is well known that there is a connection between mind and
body and that a patient’s behavior can have a dramatic impact
on how well he or she responds to treatment. Patients with behavior
problems tend to over utilize medical providers’ time and
overburden clinic resources.
The BHC work directly with medical providers in a team approach
to improve the quality of patient care. BHC spend between 15 and
30 minutes with a patient to conduct a brief “solution focused”
assessment and develop a behavioral treatment plan and offer interventions.
An initial assessment takes 30 minutes with follow-up sessions lasting
up to 15 minutes each. In this model the average number of encounters
per patient will be between 3 and 4 sessions.
Services provided by the BHC do not include traditional social
work services such as referral and resource. BHC offer psychosocial-education,
medication management, provider consultation, and brief treatment
planning to address specific behavioral changes to improve the patients’
compliance with treatment. BHC also develop behavioral health protocols
for target populations. Rather than utilizing extended psychotherapy
sessions, both BHC and medical providers follow up on the patient’s
progress during subsequent visits. When necessary, BHC will make
referrals for serious mental illness to the Center or other community
resources.
During the pilot phase of the program, two of the four CHC sites
are currently staffed with a least one BHC. The program supervisor
is also available to respond to triage and crisis intervention.
The BHC are required to have at least a master’s degree and
be licensed in Texas to provide mental health services. Staffing
these two clinics with clinical supervisors will allow the Merge
Program, working in conjunction with The University of Texas at
Austin and Southwest Texas State University, to expand into an internship
site.
The IBH model is expected to assist providers in more effectively
treating patients that present with behavioral health problems that
have an impact on their physical health. The model will also allow
the CHC clinics to provide behavioral health services to many more
patients than could have been served with the previous traditional
therapy model. At a time of serious budget concerns, we welcome
and support this exciting new model and embrace its goal to make
our CHC system more efficient and our patients healthier.
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