3215.0: Monday, November 13, 2000 - Board 4

Abstract #2858

Integrating behavioral and physical health care: a staged progression model that works

Susan M. McCabe, EdD, Professional Role - Mental Health, East Tennessee State University, P.O. Box 70658, Johnson City, TN 37614-0658, 423-439-4363, mccabes@etsu.edu and Carol L. Macnee, PhD, Family and Community Nursing, East Tennessee State University, P.O. Box 70676, Johnson City, TN 37614-0676, 423-439-7144, macneec@etsu.edu.

Integration of behavioral and physical health care is the golden ring on the merry-go-round of primary health care today. Yet structural, historical, economic and philosophical factors all conspire to keep the ring out of reach. Behavioral and physical health care have traditionally been treated as separate and distinct by insurers, educators, and providers, making integration of services a challenge which will likely require a staged progression to reach the eventual goal of fully integrated services. This paper presents three progressive models for the integration of behavioral and physical health care beginning with a parallel model, followed by an overlapping model and concluding with a synthesized model for delivery of care. The three models will be described in terms of the structure, process and outcomes of care delivery. Currently, the parallel model is most frequently implemented in settings which attempt to integrate care, and examples of this from existing health services will be described. The authors' practice experience in a setting using an overlapping model to behavioral and physical health care to homeless individuals will be the basis for describing specific structural factors, clinical and professional processes, and outcomes for this model. Their experience will be used to expand on the implementation of an overlapping model for integration of services to other settings. The goal of a synthesized model of care will be described and structural, economic, educational and philosophical factors which will need to be addressed in order to implement the model will be discussed.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Describe rationale for the current move toward integration of behavioral and physical health care 2. List the common barriers and benefits to the integration of services 3. Describe a staged progressive model for the integration of services 4. Evaluate the efficacy of staged integration through outcome measurement 5. Recognize factors needing modification in order for a system to progress towards integration of services

Keywords: Models for Provision, Partnerships

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA