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Alaskan Innovation: Full Integration of Behavioural Health Services in Primary Care

Authors:

Steve Tierney ,

Southcentral Foundation, United States, US
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Melissa Merrick

US
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Abstract

Southcentral Foundation (SCF) is an Alaska Native customer-owned health care system responsible for providing health care and related services to approximately 65,000 Alaska Native and American Indian people in southern Alaska. Approximately 20 years ago, SCF took responsibility for primary care, taking over from Indian Health Services, and made major changes to the system based on what the Native community wanted to see. This included integrating behavioral health services into primary care in response to difficulties in accessing behavioral services and high numbers of behavioral appointments that were not kept.

To make behavioral services more available to those who need them, SCF integrated Behavioral Health Consultants (BHCs) into primary care. BHCs are available to patients (called “customer-owners” at SCF) for same-day appointments, and also work with SCF’s Integrated Care Teams (ICTs) as needed on customer-owner cases. Integrated behavioral services are available to all customer-owners who visit SCF’s clinics, and BHCs can also be brought in at the request of a member of a customer-owner’s ICT. SCF has been offering integrated behavioral health services for well over ten years now, making changes and improvements throughout that time based on customer-owner and provider feedback.

When customer-owners meet with BHCs, the BHCs are often able to meet their needs with a brief intervention. If this is not possible, the customer-owner can be referred to an intake with a psychiatrist or therapist, given community case management, or referred to one of SCF’s Learning Circles (which are a form of group therapy based on the Alaska Native value of sharing and receiving story). Integration removes barriers to care, and also puts the mind and body back together, destigmatizing behavioral needs.

BHCs can also be added to a customer-owner’s care team at the request of a provider. The flexible nature of SCF’s ICTs allow for providers to be added and removed as they are needed, and BHCs can often make meaningful contributions to care even in cases that are not primarily focused on behavioral issues. For example, BHCs can often play a role in supporting customer-owners in making healthier choices in their lives, improving overall wellness.

Integrating behavioral services into primary care improved access to services, resulting in a reduction in appointments that were not kept and greatly reduced wait times for behavioral services. 97 percent of customer-owners are satisfied with the care provided by SCF. SCF has also achieved 95 percent employee satisfaction. SCF has sustained the integration of behavioral services for over ten years, and has also made an effort to share lessons learned with other organizations so they can integrate behavioral services as well.

SCF’s integration of behavioral services has shown that this kind of integrated system can improve both behavioral services and primary care. SCF is continuing to refine and improve our integrated system of care, and we have learned that looking to customer-owners and providers for guidance on how to integrate systems can result in improved outcomes and increased satisfaction.

How to Cite: Tierney S, Merrick M. Alaskan Innovation: Full Integration of Behavioural Health Services in Primary Care. International Journal of Integrated Care. 2022;22(S1):13. DOI: http://doi.org/10.5334/ijic.ICIC21005
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Published on 08 Apr 2022.

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