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.
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
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
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
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
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
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
· DETERMINE EXPECTATIONS
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
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
· CREATE EMPOWERMENT
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
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.
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
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