KRH Integrated Behavioral Health program
Written by Mary Wallace
May is National Mental Health Month, and Kalispell Regional Healthcare is offering a new program that takes a holistic approach to patient care that now includes addressing mental and emotional issues that often arise when a patient is dealing with medical conditions.
When talking about health, the focus can’t just be on heart health, or liver health, or any other physical problems without addressing the current mental health of the patient. Studies have shown that addressing the patient’s whole health and making use of the tools and resources that benefit minds and bodies together is much more effective.
The Integrated Behavioral Health program at KRH is a team-based approach to providing mental support to complement the primary care doctor’s physical support, and therefore, provide for better overall outcomes in patient care.
It is understandable that if a patient is dealing with a physical illness, injury, or medical condition, they may also experience added stress and emotional issues. The philosophy is to invest some time and care in both the patient’s mental and emotional well-being while addressing their physical health to help them navigate their journey to whole wellness.
According to Courtney Rudbach, clinical supervisor of the Integrated Behavioral Health program, the core team consists of the primary care physician, a behavioral health clinician, and a nurse navigator, all of whom work together to bring the patient the solutions and resources that will allow them to be an active participant in their own wellness.
The process usually begins at the patient’s annual wellness exam when the primary care doctor performs a brief screening. If indicated, the primary care physician can immediately have the patient seen by a behavioral health clinician for an initial consultation and evaluation of their needs. Even though this initial meeting is short, the behavioral health clinician and patient can discuss and develop brief, goal-oriented steps that can be taken to empower the patient to overcome any roadblocks to their physical and emotional well-being.
Follow up appointments are usually arranged, and the nurse navigator is often brought on board to research what community resources are available to help fill the patient’s immediate needs. Many patients receive all the benefit they need from these in-house services provided by the integrated behavioral health program, while others may be referred for more intensive treatment with a counselor or therapist. It has been demonstrated that offering these low-key mental health services to patients early in their wellness journey is more beneficial and cost-effective than waiting until they are in crisis mode to begin any kind of mental health treatment plan.
In addition to the core team consisting of the primary care physician, the behavioral health clinician, and the nurse navigator, a wider support team that includes clinical consulting psychiatrists, diabetes educators, pharmacists, and the clinical supervisor are all a part of the patient’s care. The entire team works together to make sure the patient has access to the community resources they need, and that both their physical and mental health treatment and medications are monitored and adjusted as needed. The program is available to youth, adults, and families as needed, and it all starts with a wellness visit to the primary care physician.
According the Montana Healthcare Foundation, mental illness and substance use disorders are common, and they are serious problems in Montana. Behavioral health is a term that is commonly used to describe this spectrum of illnesses and the fields of health care that address them. In surveys of health needs carried out by Montana’s local health departments and hospitals, these issues rank as the most important health challenges in many Montana communities. Among Montana youth, more than 29 percent report symptoms consistent with depression, and 23.5 percent of high school students report binge drinking within the past month.
A recent national survey examined the prevalence of behavioral health problems and corresponding access, or lack thereof, to services for treatment in each U.S. state: Montana ranked 44th worst overall and 49th for youth. A serious shortage of treatment for Montanans struggling with behavioral health disorders complicates the problem. In 2016, only 25 percent of Montana’s mental health professional needs were met, placing Montana in the bottom five of all states; 10 Montana counties had no state-approved substance use treatment program; and, Montana’s substance use treatment system met only roughly one third of the estimated need for medication-assisted therapy.
It is due to these statistics that the local KRH program, along with many other facilities statewide, received a grant from the Montana Health Foundation in June 2018, to begin the development and implementation of the Integrated Behavioral Health project. The grant provided funding for both startup and the first two years of operation. In addition, the National Healthcare Foundation provides consulting support to this effort.
After a few months of planning and logistics, the KRH Integrated Behavioral Health program was gradually initiated at individual affiliated clinics, one at a time, beginning in the fall of 2018. It is now incorporated into nine clinics across western Montana including Woodland Clinic, Family Healthcare, Kalispell Medical Offices, and Big Sky Family Medicine in Kalispell, as well as Polson Health, Westshore Medical Clinic (Lakeside), Family Healthcare–Columbia Falls, and Bigfork Medical Clinic. Flathead County Health Department and North Valley Hospital in Whitefish are also participating with similar integrated behavioral health programs.
KRH also offers integrative behavioral health in its prenatal maternal health program where mothers-to-be are able to get help during their pregnancy and after delivery when statistics show people are susceptible to post-partum depression. The team-based model of care pairs obstetric providers with a behavioral health clinician (such as a social worker or licensed addictions counselor) and includes strong care coordination and peer support to reduce the adverse outcomes of perinatal behavioral health issues and substance use disorders for newborns and their families.
In addition to serving clinical supervisor for the KRH Integrated Behavioral Health program, Ms. Rudbach has a background as a licensed addiction counselor, as well as a licensed clinical professional counselor. She is enthused to be working with such a dedicated team of physicians, clinicians, and nurse navigators to bring this new approach to whole patient care to the Flathead Valley.
“The successes are already obvious in the positive outcomes we are seeing as we work to empower patients as agents of their own recovery,” she says.