Shared Learning: What Primary Care Can Learn from Behavioral Health

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stickfigureDr. Jeffrey Brenner, MD is a primary care physician and Executive Director of Camden Coalition of Healthcare Providers. He is best known for his ground-breaking and innovative work in “hotspotting,” the concept of lowering medical costs by providing the neediest patients better health care, as featured in The New Yorker on January 24, 2011. Dr. Brenner is committed to creating a healthcare delivery model to meet the medical, mental health and social service needs of persons with serious and chronic physical and mental health conditions. He recently spoke with Meena Dayak and Heather Cobb of the National Council for Behavioral Health on what primary care can learn from behavioral health.

Dr. Brenner states that primary care has not fundamentally adjusted its operational, clinical and business model to change with today’s health care landscape and describes many of the challenges facing primary care settings in delivering robust, quality, results-oriented behavioral health care.

He emphasizes that routine work in primary care needs to be standardized, protocolized and delegated, and that behavioral specialists and community health workers need to be included as part of the care team.

Dr. Brenner also sees how psychosocial factors impact health. “If a person doesn’t have a roof over their head, if they don’t have a meal, if they’re a victim of physical or sexual abuse, if their household has a lot of stress in it, if their kids’ school is not safe, then that’s going to impact their health,” said Brenner in his interview with Dayak and Cobb.

He acknowledges that health care and social services were not always that good at coordinating with each other but that’s beginning to change.

When Dr. Brenner was asked what behavioral health providers might learn from how primary care providers are dealing with these disruptions, he had a surprising answer:

“Actually, our behavioral health colleagues are about 30 years ahead of us. I hope primary care can learn from behavioral health,” said Dr. Brenner. “When psychiatric care was deinstitutionalized, behavioral health did heroic work to figure out how to deliver better care at lower cost and evolved some creative models. The different tiered interventions provided in behavioral health and ways to engage patients are really remarkable. That is a perfect foreshadowing of what’s about to happen now on the medical side. We’re about to deinstitutionalize primary care.”

This is a great example of how “two worlds” (physical health and mental health) can come together as one to address the whole health needs of individuals and communities. It’s time to get past the silos and reconnect the mind and body. We will be a healthier people and nation for it.

One thought on “Shared Learning: What Primary Care Can Learn from Behavioral Health

    Maria del Carmen Uceda said:
    January 23, 2014 at 12:37 pm

    I very much enjoyed this article as it affirms our work at our Centro de Vidas Sanas (Healthy Lives Center, Dallas) where our network of Latino primary care physicians can entrust their patients to our care: we assess not only their behavioral health needs but also spiritual, family, social so as to surround them with the support needed as we journey in their processes of change. We know that primary care physicians are not set up to integrate behavioral health group services and do not have the expertise to address the emotional/spiritual underlying issues affecting the body and mind. Our PERDON (Forgiveness) Process enables us to journey with the person to bring healing, freedom and reconciliation with God, self and others. Without forgiveness, the body does not heal. We are proud to support our primary care physicians to address with compassion the whole health needs of patients and communities. Geat article and thanks for affirming the role of the laity as peer support is vital as they give witness through their own health transformation that gives hope to hurting people with mental health and chronic illnesses.

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