As part of an overall effort to meet growing community demand for behavioral health services, Lancaster General Health Physicians began embedding counselors within select practices in 2013.
Tracey Lavallias, LG Health Executive Director for Behavioral Health, said providing medical and behavioral health care under one roof has already shown significant benefits for both patients and physicians.
“An integrated approach to care is a growing trend nationally,” he said. “Behavioral health has a strong connection to overall health. This is an effective way to increase access to much-needed behavioral health services and fill existing gaps in the community.”
Behavioral health integrated counselors currently see patients at Family Medicine Twin Rose (Columbia and Wrightsville), Family Medicine Mount Joy and Roseville Pediatrics, as well as the Women’s Specialty Center and Ann B. Barshinger Cancer Institute.
Family Medicine Norlanco, Susquehanna and Sycamore Square will add counselors this spring. LG Health Physicians plans to offer behavioral health services at all primary-care and some specialty practices by 2019.
Master’s degree-level licensed therapists work with patients to address depression, anxiety and stress; substance abuse; and positive behavior changes around chronic health conditions, including prevention and risk reduction.
Caroline Barnhart, LG Health Manager of Integrated Behavioral Health, said the approach increases access and convenience, reduces stigma and provides more seamless, coordinated care for patients. Some areas have limited community-based behavioral-health services, and transportation barriers can prevent many patients from accessing the care they need.
“Patients who couldn’t get into behavioral healthcare are now getting care right in the practice,” she said. “Upon request by a physician or healthcare team member, an integrated counselor is available to meet with the patient in real time. That really helps support patient engagement.”
After the initial introduction, a patient may return for five to seven half-hour counseling sessions. Proximity enables the counselor and referring physician to easily track the patient’s progress and collaborate on the overall treatment plan.
Harrison McGrath, M.D.
Benjamin R. Snell, M.D.
Harrison McGrath, M.D., Managing Physician at Family Medicine Mount Joy, said embedding counselors at the practice has opened doors for patients who previously struggled to find behavioral-health care.
“The counselors at our office have become an integral part of our team, and we frequently seek their advice,” he said. “As a plus, many patients appreciate that they can see their therapist in a familiar environment with familiar staff, thus decreasing their anxiety regarding behavioral health treatment.”
A six-month pilot study at Twin Rose and Mount Joy followed 395 patients, who received an average of three brief interventions for depression, anxiety and stress. Patients showed improvements in blood pressure, A1C and depression, as well as decreased utilization of the Emergency Department and other high-cost services.
Physicians reported a high level of satisfaction with patients’ ability to access behavioral-health services and improvement in their team’s ability to provide care.
“Physicians are trained to look at the whole person, which includes addressing behavioral-health needs,” Barnhart said. “Practices that previously lacked capacity to effectively treat patients with these concerns report improved staff morale since offering behavioral-health services.”
Patient satisfaction – as reflected in Press Ganey survey scores -- also has improved at the practices.