Integrated Behavioral Health (IBH)
The Montana Primary Care Association is dedicated to the advancement of integrated behavioral health services (mental health, substance use disorders, medication for opioid use disorders) in primary care settings. The goal of primary care is to treat the whole person through maximizing a team-based approach and integrating behavioral health, dental, and resource support services. The MPCA offers training and technical support to organizations who desire to implement or increase their delivery of integrated services and reach quadruple AIM outcomes: enhancing the patient experience, reducing costs, improving healthcare outcomes, and improving the clinician experience.
IBH is a team-based approach that provides real-time teamwork with shared care plans as a standard approach to care for designated populations. This model combines a multidisciplinary team that integrates treatment strategies and interventions to provide whole person care rather than treating isolated symptoms or diagnoses. Treating these complex and/or chronic illnesses with a team approach is an innovative and evidence-based best practice in the primary care setting.
IBH services combine medical and behavioral health services for problematic, chronic, comorbid conditions to patients presenting in a primary care setting, including stressed-linked physical symptoms, health behaviors, mental health (MH) or substance use disorders (SUD). We know emotional health is connected to our physical health, hence having a multidisciplinary team providing services in one setting provides comprehensive care when working with people to improve the quality of their lives.
For immediate and specific resources please email your IBH team ibhresources@mtpca.org
Integrated care enhances the primary care team through:
- Expanding identification/screening for behavioral health/substance use disorders;
- Improving outcomes for both physical and behavioral health diagnosis;
- Avoiding hospital admissions and readmission;
- Reducing emergency room utilization for patients of the primary care practice; and
- Preparing the practice for value-based payment models, case rate and episode-base reimbursement.
Integrated care helps organizations to:
- Improve access and efficiency;
- Increase clinical effectiveness;
- Reduce per patient per month (PPM) costs; and
- Develop clean, clear, and defined team communication which produce improved outcomes and service quality.
Stigma describes the powerful, negative perceptions associated with substance use. Stigma has the potential to negatively affect a person’s self-esteem, damage relationships with loved ones, and prevent those suffering from addiction from accessing treatment. It is an attribute, behavior, or condition that is socially discrediting, and affects healthcare workers, patients, family, friends, employers, etc.
Because of stigma, some healthcare workers:
- View patients with SUDs differently; usually with more negativity;
- Have lower expectations for health outcomes;
- Believe addiction is an issue of choice and control;
- Assign fault or blame to the patient;
- Believe punishment is more beneficial than treatment; and
- View patients with an SUD as more threatening.
Stigma undermines treatment and successful health outcomes. Patients are less likely to seek or access services, will drop out of treatment early, and will be less likely to share accurate information about their health and use.
For immediate and specific resources, please email your IBH team ibhresources@mtpca.org
Substance Use Disorder (SUD) is defined by the American Society of Addiction Medicine (ASAM) as a chronic disorder that affects the reward, motivation, and memory functions of the brain based on use of substances that have a psychoactive effect. Specifically, addiction results in an inability to control substance use or abstain from using drugs or alcohol.
- Addictions are frequently chronic and episodic.
- Substance Use Disorders are genetically and environmentally influenced.
- Substances change the brain’s reward regions, leading to tolerance of higher and higher doses and habit formation due to craving responses and withdrawal symptoms.
- The negative effects (withdrawal symptoms and craving) last long after use of the substance ceases, but eventually the symptoms diminish.
- No single factor determines whether a person will become addicted to drugs, however we do know that early use, heredity, and other risk factors increase the potential to develop a substance use disorder.
- Addiction can develop in anyone.
SUD is to be treated with the same clinical concern, non-judgmental stance, and excellence as any other chronic illness.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying patients who use substances at risky levels with the goal of reducing and preventing related health consequences, disease, accidents, and injuries. Risky substance use is a health issue and often goes undetected.
MOUD is the use of medications for the treatment of substance use disorders and to prevent opioid poisoning. MOUD is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers containing opiates. The combination of MOUD and counseling is effective in assisting many people to reach remission.
The Integrated Academy brings over 100 years of Montana health care experience to your clinic door. Consultants will work together with your staff to provide seamless and hands-on, one-on-one training and coaching services to your providers, teams, and administrative staff. The Academy team will assist with integration efforts, warm handoffs, policies, workflows, and more. The Academy team will work around your clinic schedule to provide individualized and sustainable integrated health care implementation process efforts.
