Collaborative Care Model focuses on mental health in primary care offices

A physical ailment is usually obvious – you’re in pain, or your body isn’t functioning as optimally as it could. But mental pain can be harder to pinpoint, and once you recognize that something is off, it can be difficult to find treatment.

“When someone realizes they need mental health support, finding that support can be a challenge,” says Rachel Smolowitz, Ph.D., program manager of Sheppard Pratt Integrated Behavioral Health at GBMC. “It’s hard to even know what you need.”

September is Suicide Prevention Month, and GBMC is working to combat those challenges with an emphasis on behavioral health in the primary care setting all year round through their Collaborative Care Model. In partnership with Sheppard Pratt, all GBMC Health Partners advanced primary care practices have a full-time behavioral health manager available in the office or virtually to provide mental health evaluations and support almost immediately.

Dr. Smolowitz says a behavioral health program in a primary care setting is more than just a convenience for patients.

"It’s important to assess and screen anyone who may be experiencing increased anxiety and depression,” she says.

She adds that making mental health part of a comprehensive care appointment also reduces the barriers some people face in receiving care.

“Going into a psychiatry office is a stigma for some people. This breaks down that barrier and allows them to easily get the help they need in a familiar setting.”

When a primary care physician notices someone has symptoms of a behavioral health issue, they’re able to connect them with the behavioral health care manager. The behavioral health care manager does a comprehensive intake with the patient to discover what they need, whether it’s therapy, medication, or a combination of the two. They share their findings with a psychiatrist, who provides recommendations to the primary care physician.

Dr. Smolowitz says they are essentially helping patients become their own therapists. She uses an analogy of driving a bus to further explain.

“The patient has a bus, and their symptoms are driving the bus. Traditional therapy just puts the therapist behind the wheel, but we’re putting the patient in the driver’s seat and helping them learn how to navigate the route.”

She says this approach allows the care team to help hundreds of patients get the treatment they need.

Most treatment plans last around six months, but Dr. Smolowitz emphasizes every approach is customized based on the patient’s needs. Sometimes further help is needed.

“Some disorders are best treated by a face-to-face psychiatrist over a prolonged period of time, and if a patient needs something more intense, we will connect them to the next level of care,” she says.

In regard to behavioral health in a primary care setting, she adds, “In an ideal world, this would be basic care for people who don’t need the intensity of therapy and medication management.”

Dr. Smolowitz says she hopes collaborative care programs like this will continue to grow throughout the U.S. because “we want to help. It shouldn’t be that hard for patients to get help.”

She recommends reaching out to your primary care doctor if something is affecting your mental health and not fading or if you have any concerns about your mental state.

“People think they have to tough it out, but we can help build their toolbox. You’re still doing the work; we’re just helping you do it more efficiently and effectively.”