As you work toward integration, it is important to keep in mind paths and obstacles to avoid. Awareness of what not to do will help your organization succeed in integrating behavioral health and ultimately enhance patient care and health outcomes. Here is a list of things not to do while integrating behavioral health in your setting organized by section of the Playbook:
Don’t dive into integration without a plan for financing its functions.
Don’t limit your financial approach to only fee-for-services billing. Payers are testing alternative reimbursement methods, and there may be creative approaches such as subsidies from other parts of the system to help achieve financial sustainability.
Don’t maximize billing at the expense of medical and behavioral health outcomes. Even on a tight budget, don’t hire an inexpensive behavioral health professional without defined outcome goals.
Don’t assume patients know or understand the benefits of receiving integrated care.
Don’t assume patients understand how integration functions in your setting.
Don’t lecture or talk down to patients while trying to convince them to embrace integrated care. Instead, make it easier for them to recognize the benefits and engage them in these changes in the practice.
Don’t use a script that sounds hollow and staged for educating patients on integration. Instead, help each provider and staff member find his or her own words for informing patients during visits about the benefits of integrated care.
Don’t assume that every behavioral health provider can adapt his or her style to work in an ambulatory medical setting.
Don’t just “plunk” a behavioral health provider into a practice. It takes planning and preparation to add team members and implement a new service. Ongoing implementation support is needed over a period of months or even years.
Don’t assume that placing a behavioral health provider in the practice is all you need to do for success. Busy clinical teams do not always think to include the behavioral health provider in the care of appropriate patients.
Don’t rely solely on providers to make decisions about involving a behavioral health provider in patient care. Go beyond provider initiative by using protocols that identify target populations.
Don’t assume that “no news” is good news for people with common behavioral health conditions such as depression and anxiety. Checking in with the patient during and after treatment helps with identifying and addressing any setbacks.
Don’t stop communicating with patients after their behavioral health symptoms have started to improve.
Don’t set too high an expectation for the treatment timeline. Make patients aware that setbacks can occur, and make patients feel comfortable about alerting you regarding potential setbacks.
Don’t assume that non-adherence is the reason for lack of improvement.
Don’t blame the patient for non-adherence.
Don’t ignore the patient when developing the maintenance plan. Find out if the plan is feasible for the patient and fits his or her preferences and values, and be aware of potential distractions or roadblocks.