Behavioral health experts are now working hand-in-hand with primary care physicians at about 30 UCHealth primary care clinics across Colorado, providing crucial resources to patients experiencing anxiety, depression or other challenges. The addition of these services is part of a commitment UCHealth made a year ago to invest at least $100 million into behavioral health services.
“Our model is to increase access to these needed services while reducing stigma,” said Elicia Bunch, vice president of behavioral health for UCHealth. “Both lack of access and stigma have served as barriers to care throughout our state, and by integrating therapists into the primary care setting, we are normalizing these services for patients. Now when patients go to their primary care clinic, they are able to get their physical and emotional needs met in the same setting. We are treating the whole person in one location,” Bunch said.
UCHealth plans to integrate the specialists in most of its roughly 60 primary care clinics in the coming months to meet the growing demand for such services, which have been well-received by patients.
Dr. Gina Bamberger, medical director for UCHealth’s primary care clinics in southern Colorado, said she sees a sense of relief in patients when she tells them she can refer them to a specialist whose office is just down the hall.
“They don’t have to worry about going to a whole new location. They don’t have to worry about, ‘Is this going to be covered by my insurance?’ We also offer telehealth visits so they can do that from home if they prefer, too. But it’s a huge sense of relief to have it right here in a place they’re already familiar with,” said Bamberger, a physician at UCHealth Primary Care-Fontanero in Colorado Springs, which was among the first three UCHealth clinics to integrate a specialist.
Patients can be referred to a specialist for a wide range of reasons – from depression and anxiety to help for managing behavioral issues that impact their medical condition, such as stress management for high blood pressure, said Lynnay Carona, the licensed clinical social worker who works with Bamberger and other providers at the Fontanero clinic. “It’s important to be able to access behavioral health within the primary care setting because it improves outcomes both for mental health as well as medical health for chronic diseases such as diabetes, hypertension and other conditions,” she said.
This expands upon the behavioral health services that have been provided in partnership with the CU School of Medicine at clinics including UCHealth A. F. Williams Family Medicine Center – Central Park.
Dr. John Knight, a family medicine doctor at UCHealth Family Medicine – Littleton, has seen a shift in patients’ willingness to consider seeing a psychologist.
“We know that counseling is tremendously beneficial for our patients with anxiety and depression. It can be difficult to match patients with counselors. Barriers include apprehension about talking to a person the patient has never met, time, and cost. When I let my patients know we have an on-site psychologist who I work with, the reaction is one of gratitude and relief,” said Knight. “My patients trust that she and I will work together to help them navigate their emotional and mental health challenges.”
Kristin Orlowski, PhD, is the on-site psychologist working with Dr. Knight’s patients for a seamless transition – for a resource she says is needed now more than ever, as stresses have been magnified this year by a number of things including the COVID-19 pandemic. A Colorado Health Foundation poll released last month found half of Coloradans surveyed reported experiencing mental health strain because of the virus.
“Integrated primary care is a team-based approach, allowing for the assessment and treatment of the whole person including physical and behavioral health. The development of this fully integrated care model within UCHealth’s primary care clinics in 2020 couldn’t have come at a better time,” Orlowski said. “Patients have more on their plate than ever before, which puts them at greater risk for the development of physical and mental health conditions. Patients can now access integrated primary care services in the clinic or virtually through a video or telephonic telehealth visit. This versatility in visit types has allowed for reduced barriers to care during a time when patients can really benefit from the additional support.”
Dr. Daniel Zenk, a longtime internal medicine physician in Greeley, said this model has been a game-changer for the primary care clinic at the UCHealth Greeley Medical Center and its patients.
“When you take away the barriers – like the hassle of finding a professional, the step of scheduling an appointment, the concern about going somewhere you’ve never been before and uncertainty about whether your insurance will cover it or not – you make it easier and more comfortable for patients to get the help they need,” he said. “It’s a huge relief for them and makes it more likely that they’ll get the care. It’s also a huge relief for the providers because we know they are getting the help they need.”
Rachel Slick, the behavioral health clinician who works with Zenk and other internal medicine and family medicine providers at UCHealth Greeley Medical Center, underscored how the pandemic has affected everyone in some way.
“Not everyone has a mental disorder or a substance use diagnosis, but, like physical health, everyone has mental health,” Slick said. “With or without a formal diagnosis, we are all navigating unexpected life changes. Spending more time at home with family, or spending more time at home completely alone, losing a job, experiencing unforeseen financial challenges. These changes are difficult to cope with one at a time, let alone all at once like this year has presented.”
Dr. Mark Schane, a pediatrician at UCHealth Longmont Clinic, said parents feel a sense of relief when he tells them he can refer their child to a specialist whose office is in the same location.
“Having therapists embedded in our clinic has improved the ability of our patients to receive mental health services in a more timely fashion,” he said. “I also greatly appreciate being informed through our electronic health record that my patients have met with the therapist and are receiving the care that they need.”
Jenna Orosco, the behavioral health counselor who works with Schane and other primary care providers at UCHealth Longmont Clinic, said integrating behavioral health services into the primary care setting can make it easier for behavioral health providers and the primary care providers to communicate and collaborate with each other on treatment planning and streamline next steps that need to be taken. She said now more than ever is the time for everyone to disconnect and reconnect.
“Disconnect from what drains you, even if the disconnect is temporary – like the news, social media, an unhelpful family member. Then reconnect with something that fuels you – like going for a run, being creative, watching a favorite funny movie, seeing family and friends in a safe way,” she said. “Unsure where to start? Make a list of what drains you and what fuels you, then pick an item from each list, one to do less of and one to do more of.”
More on UCHealth’s behavioral health/primary care services:
- How can I get help with behavioral health care?
If you are already a patient at a primary care practice that also has a behavioral health therapist, you can seek a referral from your primary care provider to see the expert. A list of primary care clinics currently offering behavioral health services, which are available to existing patients, can be found here.
- Does insurance cover behavioral health visits?
Patients will want to check on their insurance plan specifics, but visits should be covered just like any other primary care visit because of UCHealth’s integrated focus on this care.
- Will UCHealth continue to add behavioral health experts?
Throughout the rest of 2020 and into 2021, UCHealth will continue to add behavioral health experts to primary care clinics.
- What do I do if I need help immediately?
If you are experiencing a mental health crisis, please call 911 or go to your local emergency room. Colorado Crisis Services also offers 24-7-365 support for mental health crisis by calling 844-493-TALK (8255) or by texting TALK to 38255.