​#doIBHcare Twitter Chat participants shared over 100 resources on integrated behavioral health care (IBH)

Outcomes resulting from IBH

• Study of 113,000+ patients showed the benefit of co-treating diabetes and depression
• 80+ randomized controlled trials show collaborative care is more effective than usual care
• Nurse practitioner services in mental health settings shown to address primary care needs
• A university psychiatry metabolic clinic helps people with psychosis improve A1c values through patient-centered care
• Forming a clinical relationship and providing access to ongoing care improves outcomes
• A framework for measuring integration of primary and behavioral health care
  
• Study showed benefits of peer-led self-management to quality of life, recovery, and hopefulness
• Read about one organization’s experience in integrating behavioral and physical healthcare
• Self-directed care lets people use public mental health dollars to integrate their own services with more choices
• The 8 Dimensions of Wellness helps enhance people’s physical and mental health
• Pilot project in Texas to advance peer support in community health clinics suggests a promising approach

Successes and challenges in IBH

• Infographic on the promise of integrated primary and behavioral health care
• Fresh Thinking resource on successes at system level when integrating care
• Infographic on 3 key areas for public health clinics to address when integrating care
  
• 10 key principles for successful health systems integration
• ​Obesity and smoking are significant challenges to health of people in mental health recovery, especially women
• Overcoming problems that result from reentry after criminal justice involvement
• Online diabetes education toolkit addresses the challenges posed by diabetes among people in mental health recovery
• Weight management and well-being class helps people in mental health recovery achieve greater fitness
• Academy for Policymakers offers tools and resources to address challenges in integrating care at the systems level

Addressing specific needs when integrating care
 ​

• ​Watch this free webinar on cultural competence when integrating health care for diverse individuals
• Fact sheet on reducing the disparity experienced by underserved older adults with mental health conditions
• Inclusive services at a university women’s program integrate care to address diversity, urban violence, and PTSD
• Learn how peers connect people with behavioral health conditions to community life
  
• Make it relevant by asking people what they want, especially those from culturally diverse communities
• Promote culturally and linguistically competent services to eliminate health disparities
• Use National CLAS standards to improve health outcomes
• ​One university links students to behavioral health services in a non-stigmatizing way by using the course syllabus
• Cross-training medical & behavioral providers in HIV and mental illness increases engagement in HIV-related services
• Guidance on person-centered approaches to help older adults and people with disabilities direct their own care

Culture Change for IBH

• Workforce development is essential to integrated care and helps improve attitudes
• Core competencies for integrated behavioral health and primary care
• Strategies to put patients or clients at the center of a medical home
• Get technical assistance on how lived experience is key to organizational culture change when integrating care
• Tools and tips to engage patients into an integrated medical home
• Multiple free resources on needed skills and provider roles in successful integrated care programs
• Use mental health peer providers in service delivery and training settings to change mindsets
• Hearing Voices Illinois normalizes experiences labeled as psychosis in order to promote provider culture change

Identifying and addressing barriers to IBH ​

• See how 3 states are using Medicaid to fund peer specialists in integrated behavioral health care settings
  
• 55% of U.S. counties do not have behavioral healthcare workers
• Lack of funding for research and development of care coordination models hinders advances   
• The Integration Edge shares how organizations have overcome challenges to integrate care
• Financing can be a barrier, but State policymakers have some options
• HHS’ Certified Community Behavioral Health Clinics (CCBHC) program designed to address many integration barriers
• Manual on resolving integration barriers by giving people authority over their own care
• Mental health self-directed care can help address barriers to integrated care at the client level

The role of self-help and peer support in IBH ​

• ​Peer support services help people identify options, make decisions, and navigate health systems
• Self-management skills engage people in their own care for better health and wellness
• Free webinar that reviews research on the effectiveness of peer support services
• Peers facilitate meaningful community inclusion to improve emotional and physical wellness
  
• Mental health peer support is especially beneficial for youth and young adults
• Peers leading self-help groups leads to more empowerment
• Mind/body recovery and resiliency are promoted when peer providers use their lived experience to help others
• Peer-led health education models now have research support to promote widespread adoption in integrated settings
• Peer wellness educators coupled with community health screening helps people develop greater health self-efficacy
• Facts and resources about the importance of mental health peer support to social inclusion​

Financing and sustaining ​IBH

• Webinar on best practices in sustaining on-site training of behavioral health clinicians
• Workflow redesign is critically important to sustaining integrated care
• Free tools to integrate mental and physical health, including podcasts, training webinars, and technical assistance
• New CMS billing codes support behavioral healthcare integration
• CIHS billing and financial worksheets for each U.S. State
• Information and resources on financing integrated behavioral healthcare
• The SAMHSA PBHCI program supports community efforts to coordinate and integrate healthcare
• Sustainability lessons learned from SAMHSA’s PBHCI grantees
• Help U.S. cities and regions get started on making healthier people and populations a cornerstone of their future success
  

Evidence-based practices that promote IBH ​

• Self-assessment tool to rate progress in implementing evidence-based and best practice integrated behavioral healthcare   
• Free data tool for using large public data sets to address integrated behavioral healthcare research questions
• Behavioral health homes run by university nurses at a community agency to co-locate mental health and primary care
• Several evidence-based practices help people in recovery lose weight and get fit
• WHAM is a training program and peer support group designed to increase resiliency, wellness, and self-management
• Research shows that evidence-based exercise programs are feasible and valued by people in mental health recovery
• Physical activity calendar makes getting fit fun
• WRAP is an evidence-based program to teach people how to self-manage their own mental and physical health
• Evidence-based BRIDGES classes educate people about mental health and how to navigate service delivery systems
• SAMHSA programs and resources focused on promoting and integrating behavioral health within health systems
• Evidence-based examples and models for primary and behavioral healthcare integration ​

Making IBH accessible 

• Address transportation, communication, and environmental barriers in integrated healthcare settings
• Telehealth, mobile apps, home visits, and provision of transportation can be used to increase access to integrated care
• By co-locating primary and behavioral healthcare, patients have access to coordinated care at the same site
• Use this client care toolkit to assess patient satisfaction with integrated care
• Educate staff and facilities with these free fact sheets about making health care more accessible for people with disabilities
  
• Learn about why language matters in mental health
• Help journalists understand mental health and substance use issues to decrease stereotyping in reporting

Engaging primary care providers in recovery

• ​Learn the guiding principles for integrated behavioral healthcare workforce development
• Emphasize to primary care providers that recovery is possible
• Help providers learn that the goal is recovery and wellness, rather than symptom management
• Health fairs bring together primary care, peers, and mental health providers to screen and educate people in recovery
• Teach motivational interviewing to the primary care and mental health workforces
• Train primary care and mental health providers about recovery-oriented and trauma-informed care
• Train primary and behavioral health care practitioners on evidence-based, integrated care models
• Help primary care providers see how physical health and mental health go hand-in-hand
• ​SAMHSA’s Recovery to Practice program helps providers improve the delivery of recovery-oriented care
• Employ peer staff in Behavioral Health Homes to expose primary care providers to recovery principles and exemplars

Role of the 21st Century Cures Act in IBH

• Potential for Cures Act to promote integrated behavioral healthcare, especially teamed with HHS’ CCBHC program
• Cures Act clarifies that payments for mental health and primary care on the same day are not prohibited under Medicaid
• CMS to issue State Medicaid letter on opportunities to design innovative behavioral health systems under the Cures Act

Learn more about ​IBH

• Interactive Quick Guide walks through questions to consider when integrating care
• Video about the value and core components of integrated behavioral healthcare
• Fact sheet explaining different integrated care models
• Infographic on level of medical and behavioral health care integration achieved
  
• The Center for Integrated Health Solutions (CIHS) offers many IBH resources
• CIHS also offer resources and tools to support integration efforts within clinical practice
• The AIMS Center advances integrated mental health solutions
• The Collaborative Family Healthcare Association promotes comprehensive and cost-effective integrated care
• The Center of Excellence for Integrated Care helps health clinics and systems to integrate physical and mental healthcare
• How prevention, early detection, and integrated behavioral healthcare improve individual and community health

Continue to follow #doIBHcare @UICHealthRRTC for additional news, resources, and perspectives on behavioral healthcare integration. Find a recap of the chat on Storify.  

Views expressed on the Academy for Policymakers web site do not necessarily represent those of our Center or any federal agency. Our mission is to share the latest policy information and the perspectives of a variety of stakeholders without endorsement.