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Eight Steps for Creating Successful Behavioral Health and Primary Care Partnerships

Posted By Cheryl Holt, Thursday, January 26, 2012
There are numerous initiatives underway that address the primary care needs of people with behavioral health disorders. It is heartwarming to see the silos begin to develop cracks, allowing the primary care folks and the behavioral health folks to engage in serious conversation about how they can work TOGETHER to serve this vulnerable population.

It isn’t easy for two disparate groups to work together. It takes considerable planning, patience, and commitment. Despite the fact that both primary care and behavioral health are healthcare fields, they have vast differences. Their cultures, funding streams, philosophies, and overall approaches to treatment vary greatly. Therefore, it is not an easy task for these two groups to collaborate together to serve individuals with behavioral health disorders….yet they are doing just that! The mission is far greater than are the differences! It is worthwhile to devote the necessary time, energy, resources, and focus to develop strategies for streamlining the integration process. Whether the services are provided in the primary care clinic or in the behavioral health clinic, working collaboratively provides enhanced results.

For a successful behavioral health – primary care partnership, these eight steps that were adapted from "Strategies to Preserve Public-Private Partnership ‘Best Practices’: Keys to Genuine Collaboration” by Greg Schmieg and Bob Climko, will provide the foundation for success:

· ESTABLISH THE MISSION OF THE PARTNERSHIP
It is vital for both organizations to sit down together and create a shared vision. This will likely require a merging of goals into a partnership mission statement. This mission statement must be communicated with everyone involved in the partnership. The success of the partnership will depend on frontline champions. They need to be identified and empowered from the onset. They will provide the energy to motivate other team members.

· IDENTIFY A COMMON LANGUAGE
Primary Care and Behavioral Health speak different languages; therefore, a common language must be identified. Clarity of communication enhances mutual understanding of cultures, roles, and expectations. While these differences might not seem important at the onset, it will become increasingly important as the partnership progresses. Most likely, each partner has a different language for many things. There are notable differences between contract deliverables, medical records, coding, management structure, procedures, and even the language used in describing the clients/patients/consumers/members/individuals served.

· MAINTAIN PACING, FLEXIBILITY, AND CAPACITY
It is very important to temper expectations within the partnership. Establishing regular meetings will help to promote ongoing communication. Mutual goals and disappointments should be continually communicated so that they can be addressed immediately. The partners must remain flexible in order to sustain a healthy partnership.

· DEVELOP SHARED SOLUTIONS
The decision makers must be open to new ideas and problem solving. Developing shared solutions maximizes organizational efficiency and capacity. Everyone must have skin in the game! Compromise is important for success.

· DETERMINE EXPECTATIONS
The project should first be piloted to allow for evaluation and for adjusting expectations to ensure that both partners are on the same page. Internal conflicts are inevitable and should be discussed openly. The partners must address differences of opinions on an ongoing basis. Partnerships create an opportunity for enhanced outcomes through blending of resources to maximize the capacity of each organization.

· DELEGATE TRUST
Face-to-face meetings are essential for establishing and maintaining trust among partners. Be sure to focus on building trust at all levels. Face-to-face time creates a forum for maintaining checks and balances to ensure fidelity to the mission. Constantly solicit feedback from partners at all levels.

· CREATE EMPOWERMENT
Success is dependent on the involvement of everyone. This requires empowering champions at all levels to move the mission forward. This empowerment develops buy-in among staff. Communicating with everyone and soliciting feedback ensures ongoing focus on the mission. Be sure to create a forum that allows both positive and negative feedback.

· MEASURE OUTCOMES
Establish the outcomes to be measured early in the project. Be prepared to modify outcomes as needed. Don’t overlook the benefits of partnership that include more efficient allocation of resources, less duplication of services, increased choice among clients, and the synergistic effect of the partnership resulting in enhancing the lives of those we serve.
Following these eight steps will assist in bridging the innate differences between behavioral health and primary care to ensure a successful partnership. Far too many promising partnerships have been derailed due to poor communication and lack of planning. Careful preparation at the onset will ensure a productive partnership that will ensure a focused mission aimed at addressing health disparities among people with behavioral health issues.


Cheryl Holt, MA, NCP, BCCP currently serves as the Director of Training and Technical Assistance with SAMHSA-HRSA Center for Integrated Health Solutions for the National Council for Community Behavioral Healthcare. She is moderator of the Behavioral Health – Primary Care Integration Listserv, manages the Behavioral Health Integration blog, and is active in social media: Twitter, @cherylholt and @BHPCIntegration; and Facebook, Behavioral Health Integration


Blog Disclaimer: 

The view expressed in the blogs and comments should be understood as the personal opinions of the author and do not necessarily reflect the opinions and views of the Collaborative Family Healthcare Association (CFHA). No information on this blog will be understood as official. CFHA offers this blog site for individuals to express their personal and professional opinions regarding their own independent activities and interests.

Tags:  family medicine  health policy  Integrated Health 

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Jennifer Hodgson says...
Posted Saturday, January 28, 2012
Well stated Cheryl. I will make sure students read this post and remember there are building blocks to success. Clearly some creative member could find a way to organize it and come up with a pneumonic for it.
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