Providers Are Leveraging the Power of Collaboration

Leaders of behavioral health treatment organizations want to believe they can offer optimal care to anyone they might encounter. But the presence of many lingering barriers to care in addiction and mental health services suggests that the impact of collaboration with other providers can be so much more effective than relying on the power of one.

Siloed treatment has been the historical norm in much of the behavioral health industry. The structure of public funding streams, the persistence of societal stigma, and the general medical community’s lack of training in addiction and mental health treatment and recovery all have contributed to fragmented care. These challenges have stymied collaboration on many levels, including between substance use and mental health providers and also in behavioral health integration’s into primary healthcare.

Behavioral health providers as a group have also hesitated to embrace the potential of collaboration, but the tide is shifting as new models of care have emerged. There has been growing evidence that when primary care providers ask the right questions of their patients and establish strong linkages with behavioral health resources in the community, they can reach individuals who might tend to avoid discussing a mental health or substance use problem with a professional.

Collaborative care is now considered a validated model of service in  behavioral health and general medicine. This is being demonstrated in locations such as the University of Pennsylvania Health System, where clinical leaders implement the Penn Integrated Care model. An American Medical Association (AMA) report in late 2020 explained that screenings for depression, anxiety and alcohol use disorder all have become a routine part of intake for all primary care visits in the organization.

When a screening reveals a potential concern, a more thorough assessment takes place. The primary care physician, a consulting psychiatrist and the patient all are involved in determining whether the individual is most ideally treated in a primary care or specialty behavioral health setting.

Cecilia Livesey, M.D., chief of integrated services in psychiatry at the university’s Perelman School of Medicine, described the protocol as normalizing the experience of seeking behavioral health treatment. “You come in for a checkup for something routine and your mental health is a part of that, you increase the comfort level. The framing and the language and the context increase the likelihood that a patient will be open to some of these interventions.”

Clinicians who have implemented this integrated model at Penn Medicine have reported encouraging results, including higher-than-average remission rates for patients’ depressive and anxiety symptoms. They also have reported higher professional satisfaction in being able to work collaboratively with experts from other disciplines, and in having the tools to offer a proper response to important patient concerns.

“I used to feel like I was at sea with no life preserver when it came to mental health care for my patients,” Matthew Press, M.D., medical director of the primary care service line at Penn Medicine, said in the AMA article. “I just didn’t have the tools to help. But with collaborative care, now I do.”

In substance use treatment, the emergence of more evidence-based treatment options has made collaborative care more feasible. The availability of office-based medication treatment for opioid use disorder now means that primary care physicians can play an important role in caring for these patients in less intensive settings, complementing the efforts of behavioral counselors and recovery support organizations.

According to an American Psychiatric Association fact sheet on using the collaborative care model to treat substance use disorders, use of the model requires the availability of consultation from an M.D.-level specialist, such as a psychiatrist or a specialist in addiction medicine. Also, “The treating practitioners will need to be willing, knowledgeable, and have prescribing authority for medications that treat substance use disorders,” the authors wrote.

Realizing the promise of collaborative care also requires having the technological tools that enable seamless care coordination. We at Sigmund Software built our AURA software solution with this commitment to integration in mind. AURA integrates with more than two dozen industry-leading software products, making it an ideal component of collaborative care.

When like-minded individuals work together to break down barriers to care, patients and communities reap the benefits. Let’s partner toward achieving the kind of collaborative care that will truly move the needle on patient outcomes.