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Define behavioral health.
Contributions of human behavior, individually and socially, to physical, mental and spiritual health. Behaviors, states of mind and emotion that enhance health and well-being as preventative and treatment applications. Destigmatizing patients seeking mental health care. Examples: suicide prevention, resiliency training
How do behavioral health consultants work with primary care providers?
To assist in identifying and managing problems such as mental health problems, psychosocial problems, risky health behaviors, chronic pain and medication non-adherence.
What is the Quadruple Aim model?
- Part of military health system. Four main goals that guide the MHS in setting short-term goals and developing long-term planning.
- 1. Readiness: making sure forces are medically ready to deploy; making sure medical force is prepared to deliver health care anytime, anywhere
- 2. Population Health
- 3. Positive Patient Experience of Care: family-centered treatment, compassion, convenience, impartial/unbiased treatment, safe treatment setting and application, highest quality of care
- 4. Responsibly Managing Total Health Care Costs: focus on cost over time, not the cost of a single treatment
How is the management of costs improved?
- 1. Focusing on quality of treatment
- 2. Reduction in wasted resources
What is Patient Centered Medical Home (PCMH)?
Form of care where a team of healthcare providers interact systematically to meet the behavioral health and health needs of their patients through collaborative development of treatment plans, provision of clinical services and coordination of care. Not a specified model of care; includes a range of models that fall under this umbrella term
What are the two PCHM models of care?
- 1. Care Management Model
- 2. Primary Care Behavioral Health Model
Define the Care Management Model.
Population-based model typically focused on a discrete clinical problem (i.e. depression, PTSD). PCMs follow systematic pathways to address BH problems. BHP is not a member of the team. Example: Army Re-Engineering Systems of Primary Care Treatment in the Military (RESPECT-mil)...know this is specifically an ARMY program
Define the Primary Care Behavorial Health Model
Population-based model focused on all enrolled patients (i.e. depression, anxiety, substance abuse...). BHP is incorporated into the team; BHPs and PCMs share patient info, medical records and coordinate health care plans; BHP sees patients in 15-30 minute appointments. Example: Navy and Air Force BHPs in Primary Care.
Prevalence of BH Problems. (Majority, minority or 50/50?)
1. Most common physical complaints have no identifiable organic etiology.
2. People with BH disorder visit PC at least once a year.
3. Number of BH disorders treated in PC
4. Number of appointments for all psychotropic agents are with a non-psychiatric PC provider.
- 1. Majority (84%)
- 2. Majority (80%)
- 3. 50/50 (50%)
- 4. 50/50 (48%)
Unmet BH Needs in PC (Majority, minority or 50/50?)
1. Number with a BH disorder that do not get BH treatment.
2. Number of referrals from PC to an outpatient BH clinic don't make 1st appointment
3. Number of PCMs can only sometimes, rarely or never get high-quality behavioral health referrals for patients.
- 1. Majority (67%)
- 2. 50/50 (30-50%)
- 3. 50/50 (50%)
BH disorders account for ___ as many disability days as "all" physical conditions.
1/2 as many days
Annual medical expenses for patients with chronic medical AND BH conditions combined cost __% more than those with only a chronic medical condition.
Top 5 conditions driving overall health cost
- 1. Depression
- 2. Obesity
- 3. Arthritis
- 4. Back/neck pain
- 5. Anxiety
Health care use/costs are __ times as high in diabetes and heart disease patients with depression.
2 times as high
List some current challenges in providing BH care with respect to the military.
- Variability within and between services
- Access to services
- Different models of service
- Fidelity to service model
- Consistent provider availability
- Different way of approaching medicine and health care
What are the names of the different BH care programs for the Army, Air Force and tri-service?
- Army: RESPECT (care management model)
- AF: BHOP (Behavioral Health Optimization Program; primary care behavioral health model)
- Triservice: REHIP (Re-engineering healthcare integration programs); aims to combine best practices from each service to create one tri-service approach
Courage to Care Campaign (USU)
electronic health campaign with fact sheets on timely health topics relevant to military life that provide actionable info
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE)
makes sure the current programs for psychological health and TBI are effective in ensuring DoD meets the needs of the military, warriors and families
Defense and Veterans Brain Injury Center
state-of-the-art medical care, innovative clinical research initiatives and educational programs
Center for the Study of Traumatic Stress
preparing for and responding to psychological effects and health consequences of traumatic events (hurricanes, floods, MVA, plane crashes, terrorism, etc.)
Center for Deployment Psychology
promote education of psychologists and other BH specialists about deployment issues
PDhealth.mil: Deployment Health Clinical Center
designed to assist clinicians in delivery of post-deployment health care
National Center for Telehealth and Technology
"National Center for T2"; deals with technologies for psychological health and TBI across DoD
National Intrepid Center of Excellence: NICoE
holistic approach to the referral, assessment, diagnosis and treatment of those with complex TBI and psychological disorders
Force Health Protection and Readiness
DeployMED Research Link
Behavioral health has become an important area in both military and civilian sectors. BH refers to enhancing physical, mental and spiritual well-being through the collaboration of various specialties to prevent and treat mental, physical and emotional health problems. All of the following statements regarding behavioral health in the armed forces are true EXCEPT:
A. BH emphasizes destigmatizing mental health care relevant to physical, mental and emotional health
B. BH includes contributions of human behavior, individually and socially, to physical, mental and spiritual health.
C. The armed forces and Military Health System have identified BH as a priority.
D. BH consultants work collaboratively with primary care providers to assist in identifying and managing physical and mental problems even though this approach increases long-term health care costs.
E. Integrated collaborative BH involves the interaction of BH and primay care providers to provide treatment, services and care to meet patients' BH needs.
Several behavioral health programs have been created to provide service members with clinical care, treatment and services to treat BH problems. Linda is an E-2 in the Army who is suffering from anxiety, mild depression and high stress that is deleteriously affecting her work performance. She is encouraged to use the Army's BH program, ________.
A. Behavioral Health Today
B. Behavioral Health Optimization Program
D. National Care Facilitator Program
E. Re-Engineering Systems of Primary Care Treatment in the Military
The Armed Forces have identified behavioral health as important for a variety of reasons including all of the following EXCEPT:
B. Suicide prevention
C. Immunization and Sanitation
E. Pre and post-deployment health assessment
Integrated Collaborative BH (ICBH) in Primary Care presents an approach that involves the primary care physician in the treatment of behavioral health problems. Which of the following is NOT one of the reasons ICBH must be an integral part of the patient's primary care management?
A. BH disorders account for one-half as many disability days as "all physicial conditions" creating a high cost when BH needs are unment.
B. Nearly all of the most common patient complaints have an easily-identifiable organic etiology.
C. Nearly half of all appointments for psychotropic agents are with a PC provider who is non-psychiatric.
D. One-half of all BH disorders are treated in PC, however, 2/3 of the individuals with a BH disorder do not get BH treatment
E. Nearly half of all referrals from PC to an outpatient BH clinic do not make an initial appointment.