Integrating Mental and Behavioral Health into Primary Care Clinics to Develop a System of Care Following the Deepwater Horizon Oil Spill

摘要

1. This presentation will focus on the importance of behavioral health services in meeting community, physical and mental health needs. 2. The Mental and Behavioral Health Capacity Project (MBHCP) is part of the Gulf Region Health Outreach Program (GRHOP), covering impacted coastal regions of Louisiana, Mississippi, Alabama, and Florida. In collaboration with the Primary Care Capacity Project (PCCP) and other GRHOP projects, MBHCP is tasked with developing a sustainable system of mental and behavioral health care, decreasing barriers to care, and increasing access to care within primary care clinics. MBHCP directly delivers evidence-based therapeutic and supportive services to the clinics with on-site and telemedical psychiatric and psychological consultation and centralized care management. Lending relevance to the work, community surveillance data collected by LSUHSC Department of Psychiatry (the Louisiana MBHCP partner) in the Fall of 2010 and again one year post oil spill revealed increased symptoms of depression, anxiety and post-traumatic stress compared to national norms, with symptom scores higher for individuals directly impacted by the spill. A higher sense of ability to cope or bounce back from adversity was associated with fewer mental health symptoms. 3. Louisiana MBHCP data shows that a large number of clients are being referred by primary care providers for collaborative mental health services. The data show that the integration of mental and behavioral health services into primary care clinics has resulted in significant decreases at follow-up of depression, generalized anxiety and post-traumatic stress symptoms. Additionally, a greater decrease in mental health symptoms correlates with a greater decrease in physical health symptoms. Clinic feedback indicates enhanced comfort in dealing with complex mental health conditions. 4. Attention to the ecosystem is of fundamental priority in dealing with the impact of the Deepwater Horizon Oil Spill. It is important to address the interdependence of the multiple components of the ecosystem and the importance of integration of mental and behavioral health services into primary care. Evidence-based mental health consultations and therapeutic services delivered onsite and with telemedicine can significantly improve physical and mental health of clients. Vicarious traumazation of clinic staff can be addressed, and clinic resilience to future disasters can be increased.