|Source||National Association of State Mental Health Program Directors (2005)|
|Year of Publication||2005|
|Selection||Healthcare policy; Grey literature|
The National Association of State Mental Health Program Directors (NASMHPD)Medical Directors Council developed this eleventh technical paper through a series of pre-meeting conference calls, review of materials and a work group summit of medical directors and commissioners as well as researchers and other technical experts.The work group reviewed current literature, consulted with leading researchers and provider organizations that are successfully implementing integration models for "safetynet" populations, and shared examples of efforts underway at state and local levels. Thereis ongoing research regarding the medical cost offsets that may accrue through provisionof Behavioral Health (mental health and substance abuse) as well as Behavioral Medicineservices to the primary care population, including early screening for and delivery ofSubstance Abuse (SA) services in Primary Care (PC) - thus, the report generally references Behavioral Health (BH) services rather than solely Mental Health (MH) services.The discussion considered both population-based and person-centered approaches to care. Recognizing that the emphasis and level of activity will vary from state to state, the report focuses separately on the need for overall system coordination, the needs of persons with serious mental illness, and needs of populations served in primary care.The report integrates two conceptual models that assist in thinking about populationbased and systemic responses. The first, The Four Quadrant Clinical Integration Model, is a population-based planning tool developed under the auspices of the National Council for Community Behavioral Healthcare (NCCBH). Each quadrant considers the Behavioral Health (SA and MH) and physical health risk and complexity of the population subset and suggests the major system elements that would be utilized to meet the needs of the individuals within that subset of the population. The quadrants can be briefly described as: I. The population with low to moderate risk/complexity for both behavioral and physical health issues. II. The population with high behavioral health risk/complexity and low to moderate physical health risk/complexity. III. The population with low to moderate behavioral health risk/complexity and high physical health risk/complexity. IV. The population with high risk and complexity in regard to both behavioral and physical health. Additionally, the report references The Care Model, which summarizes the basic elements for improving care in health systems at the community, organization, practice and patient levels. The Care Model was developed by the Improving Chronic Illness Care Program to speed the transformation of healthcare, from a system that is essentially reactive - responding mainly when a person is sick - to one that is proactive and focused on keeping a person as healthy as possible. The Council commissioned this report with attention to: 1. The new role of Community Health Centers in providing behavioral health services and the need for collaborative planning due to this new role; 2. The needs of the people served by state mental health authorities; and, 3. The evidence for integrating behavioral health services into primary care. Each of these are briefly discussed below, along with selected recommendations from the full technical report, which is organized into segments on Overarching Focus: Overall System Coordination (Quadrants I, II, III and IV); Population Focus: Serious Mental Illness/Substance Abuse (Quadrants II and IV); and Population Focus: Primary Care (Quadrants I and III). Each segment includes an overview and discussion of related research as well as detailed action recommendations. Footnotes can be found at the end of the full report.
|Additional||More about this reference (PDF - 0.49 MB)|
|Note||This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.|