Psychiatric Nurse Practitioners as Leaders in Behavioral Health Integration

Abstract

With up to 70% of primary care visits prompted by psychosocial concerns, busy primary care clinics are increasingly addressing complex behavioral health (BH) needs. Substantial evidence demonstrates that the integration of BH into primary care improves access and outcomes, yet clinics face significant challenges in real-world implementation. This collaborative care integration project used psychiatric mental health nurse practitioner faculty as integration and BH specialists at an urban primary care clinic serving a diverse and largely indigent population. The project weathered leadership changes, information system shortcomings, and a shift to telehealth during coronavirus disease 2019. The initial outcomes include increased levels of integration and improved depression and diabetes metrics.

Enhancing GP care of mental health disorders post-COVID-19: a scoping review of interventions and outcomes

“…A study involving a new integrated primary care team, with the primary care physician collaborating with a behavioural health care manager and a psychiatric consultant to treat patients with mental health disorders had positive results (Birch et al . 2021). In a RCT Community Healthcare Workers (CHW) provided psychosocial support, resulting in significant improvement in participants self-rated psychosocial health, and high participant satisfaction (Vanden Bossche et al .…”

“…2021), the ‘Nine-item Patient Health Questionnaire’ (Birch et al . 2021, Cigrang et al . 2017, Kerst et al .…”

Improving Access to Integrated Behavioral Health in a Nurse-Led Federally Qualified Health Center

“…The integration of psychiatric mental health nurse practitioners (PMHNPs) and behavioral health services into the primary care environment has been highly effective for patients with anxiety and depression (Birch et al, 2021). Sheridan Health Services is a nurse-led federally qualified health center and faculty practice of the University of Colorado providing care to over 5,000 patients in an urban city in the West.…”

Clinical trials during pandemic in primary care: Low number and low validity after one-year experience

“…In addition, PC trials usually did not focus on high-risk populations [ 14–18 ], including older patients and people with underlying health conditions. There was only one trial on nursing home residents [ 9 ]; and three trials on participants with chronic diseases [ 3 , 4 , 11 ]. Moreover, published trials did not focus on under privileged populations as defined by social determinants of health.…”

“…Feasibility outcomes, including home monitoring and programme changes after feedback, were also reported. Few trials on patients with chronic illness evaluated both patient health outcomes [ 3 , 4 , 11 ], i.e. depression symptom control, patient satisfaction and health services outcomes, i.e.…”