Journal of Clinical Psychiatry in Medical Settings Promoting Mental Health Equity: The Role of
Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.

The Readiness for Integrated Care Questionnaire (RIC-Q): A New Tool to Assess Readiness to Integrate Behavioral Health and Primary Care

Primary care settings play a critical role in meeting our nation’s healthcare needs, with the majority of people receiving care for mental health problems, substance abuse disorders and general illnesses in these settings (Kessler et al., 2005). Legislative changes in health care (e.g., Patient Protection and Affordable Care Act) and growing emphasis on care coordination have catalyzed efforts to integrate behavioral health services in primary care settings across the United States. Drawing from our work on a multi-year integrated care initiative (Integrated Care Leadership Program) and an implementation science heuristic for organizational readiness (Readiness = Motivation x General Capacity and Innovation-Specific Capacity, R=MC2; Scaccia et al., 2015), this article describes the development and implementation of tool to assess organizational readiness for integrated care, referred to as the Readiness for Integrated Care Questionnaire (RIC-Q). The article includes insights from the pilot use of RIC-Q and highlights practical implications of the new tool for integrated care efforts.

30th Annual Research & Policy Conference on Child, Adolescent, and Young Adult Behavioral Health,
Tampa, Florida

This session presents our on-going efforts to increase readiness for integrating behavioral health and primary care services in a diverse set of healthcare practices via the Integrated Care Leadership Program (ICLP). The ICLP is a multi-year initiative aimed at learning collaborative promoting health equity among vulnerable populations through developing the capacity of health leaders. In this session, we will describe the ICLP hybrid model of capacity building structure, and discuss how the Readiness for Integrated Care Questionnaire (RICQ) is being used to assess and improve integrated care efforts.

29th Annual Research & Policy Conference on Child, Adolescent, and Young Adult Behavioral Health,
Tampa, Florida

(Conference Agenda) This session will present an emerging body of scholarly work on organizational readiness using the R=MC2 heuristic (Readiness=Motivation and General Capacity and Innovation-Specific Capacity) and describe its multi-pronged utility for integrating behavioral health and primary care. We will share results from our Readiness for Integrated Care Questionnaire and provide lessons learned. This session aims to stimulate dialogue around how a heuristic for organizational readiness can be used to address the complex, dynamic needs of healthcare organizations.

APHA 2017: The Albert Einstein Effect: Achieving the Promise of Integrated Care

Practices that effectively integrate behavioral health services and primary care have been shown to improve clinical outcomes and quality of life for healthcare consumers. Additional benefits include enhanced team performance, increased mental health and well-being, improved satisfaction, and health system cost savings.

The Satcher Health Leadership Institute at the Morehouse School of Medicine’s (SHLI/MSM) Division of Behavioral Health developed the Integrated Care Leadership Program (ICLP) to provide clinical and administrative health care professionals with the knowledge and training needed to successfully develop integrated care practices. The ICLP aims to address mental health disparities via integration of behavioral health into primary care and as a pathway to achieving the Institute for Healthcare Improvement (IHI) Triple Aim (improving the patient experience of care, including quality and satisfaction; improving the health of populations; and reducing the per capita cost of health care) and to advance health equity. Finally, an important charge of the ICLP is to increase readiness for integrated care practice and to optimize positive clinical outcomes.

Eleven primary care and behavioral health practice sites are currently enrolled in the program and completed baseline self-assessments. The program consists of an online curriculum, coaching calls and webinars designed to develop transformative leadership within each organization. Additionally, site visits were conducted by program staff to review current practice and inform technical assistance efforts. This presentation will examine the development, implementation, and preliminary evaluation of this innovative learning collaborative. Lessons learned from preliminary program evaluation data will be discussed through review of quantitative and qualitative data, including a readiness for integrated care-questionnaire (RIC-Q) administered at baseline and 6 months. Mean baseline readiness scores revealed participating sites were generally highest on motivation and lowest on innovation specific capacity for integrated practice. Although readiness assessment results at 6 months failed to reveal statistically significant changes at the aggregate level, documented improvements in behavioral health screening practices across participating sites suggest the ICLP may be a promising model for enhancing readiness for integrated practice. Additional implications for policy, research, and practice will be explored, with an emphasis on strategies for supporting organizations in successfully implementing integrated practice in challenging policy environments.