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Medical and Research News

Title

Showcasing Behavioral Health Integration on Senior Scholarship Day

Medical and Research News

Date
04/13/2015
Article

Senior Scholarship Day is an opportunity for graduating students of the David Geffen School of Medicine at UCLA to showcase the research projects they've completed in the last year.

One of these talented students, Brittany Dixon, will be presenting her work on behavioral health integration, a subject she has studied in the process of earning both her medical degree and master's degree in public health.

Dixon's interest in healthcare was piqued as a child when she saw the difficulties her family faced while receiving the necessary care for her brother in their small hometown. Through this experience, she came to understand the interdependence of physical and mental health, and the challenges faced by the healthcare system in addressing the needs of children and adults with complex behavioral abnormalities. Since then, she chose to attend UCLA for its concurrent degree program in medicine and public health to focus on reducing these disparities.

The need for behavioral healthcare

Patients who suffer from a severe mental illness may have difficulty managing every aspect of their lives, including their physical health. Patients with schizophrenia, as observed by the Schizophrenia Research Forum, were much less likely to receive needed medications to manage their cholesterol, diabetes and blood pressure. Behavioral health disorders have a pervasive effect on the rest of the patient's life. This makes navigating the healthcare system difficult, if not impossible.

Study design

For this reason, Dixon chose to focus her research on data gathered from patients enrolled in a low-income health program (LIHP) and who have been seen at community clinics designated as patient-centered medical homes (PCMH). Facilities earn this recognition by meeting criteria defined by the U.S. Department of Health & Human Services, which requires a team-based approach to primary care. To be included in her study, the selected PCMH had primary care services and at least one kind of behavioral health provider: either a psychiatrist, psychologist, therapist, mental health nurse practitioner or social worker.

A patient who visits a PCMH clinic is seen by a primary care provider (PCP), who would perform a behavioral health assessment and, if needed, refer the patient across the hall to the behavioral health provider. This provider would then perform an in-depth assessment and develop a treatment plan in conjunction with the PCP who originally addressed both physical and behavioral needs.

Results

Data gathered from the LIHP program was analyzed to determine what effect behavioral health integration had on patient visits. The analysis showed that patients who were treated with the PCMH model experienced a significant decrease in both office and emergency room visits. Hospitalizations dropped by more than half, as well. Patients with a behavioral health diagnosis and who were treated at PCMH clinics by behavioral health providers experienced the biggest decline in visits, indicating they received the care they needed while at the clinic.

Dixon's research adds further evidence that behavioral health integration in the primary care model improves treatment outcomes for patients with behavioral health issues. The PCMH model, in tandem with more communication among primary care and behavioral health providers, should be encouraged to improve patient care for people who suffer from a mental illness.

Research is key

In describing the importance of continuing research, Dixon says "in our system, one of the best ways to create change is through policy. The best way to support the policy process is by conducting high-quality research that accurately examines the issues at hand."

She plans to continue her research to find ways to reduce health disparities, especially among the incarcerated, and is currently working on a book about the subject.

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