Sandra Bailly, M.S.W, of the Simmons School of Social Work, interviewed Alexander Blount, Ed. D., Director of the Center for Integrated Primary Care at the University of Massachusetts Medical School. This interview outlines what social work students should expect when learning about the practice of integrated primary care, as well as the training implications for those in that field. Dr. Blount says that social workers and primary care providers (PCPs) face many of the same challenges because the majority of behavioral health issues will only ever be treated in the primary care setting. In integrated care settings, health professional teamwork is key. Confidentiality is slightly different in integrated settings from what a traditional therapy practice uses. Dr. Blount states:
“The unit of confidentiality in [traditional specialized] mental health is between the therapist and the patient, whereas the unit of confidentiality in primary care, and in medicine generally, is between the patient and the team.”
To fully treat a patient, PCPs and behavioral health providers must be able to share patient information. Electronic medical record (EMR) systems are a beneficial technology for this task, and social work students should learn how to use them, and how to communicate with the PCP with them. Also, in primary care settings, therapists must be prepared to treat patients within briefer periods of interaction, and those interactions should involve teaching patients skills for dealing with their behavioral health issues.
Behavioral health and medical conditions often co-occur. So, social work students need to know how to access medical information and be able to look up unfamiliar definitions. They should also have some expertise in behavioral medicine, which involves techniques like motivational interviewing.
Prevention is a large part of the integrated care model. Integrating behavioral health with primary care helps prevent patients from having to go to specialty mental health facilities because there are opportunities for intervention much earlier in the course of their issue or illness.
The current reimbursement system is one of the roadblocks to the integrated care model. Behavioral health interventions provided may not be billable, despite their effectiveness.
Dr. Blount recommends that schools of social work create tracks or concentrations for primary care behavioral health. Social workers that handle behavioral interventions and address the social determinants of health are essential and will be increasingly sought after.
The entire interview is available at: Integrated Primary Care: Practice and Training Implications