Improving public behavioral health access for minority populations in the Southwest using a combined integrated care and promotora model

The presentation will discuss the Arizona State Division of Behavioral Health's (DBHS) development of a pilot integrated care model to improve behavioral health access for Hispanic and Latino recipients. The Arizona “carve out” public behavioral health system is challenged by disparity; fewer minority clients enroll in behavioral health services, and, due to difficulties navigating the referral process, are often “lost in the system” when referred to mental health services by their PCP. Moreover, research demonstrates that many Hispanics prefer to receive behavioral health care in a medical setting. The Arizona model combines two culturally competent approaches to improve recipient access: screening, brief intervention, intake and referral services by bilingual clinicians at primary care clinics and “promotoras” (community based health educators) trained in popular education and behavioral health. Promotoras are responsible for follow-up visits to assure satisfaction with services and behavioral health promotion with clients and family members after referrals to community agencies are made. The model aims to increase rates of referral, enrollment and retention of Hispanic recipients in the behavioral health system, improve coordination of care, support the cultural competency and clinical knowledge of behavioral health and medical providers through training and collaboration, and decrease social stigma. The presentation will pay special attention to the challenges and questions involved in administering the community based model, such as how to support necessary community buy-in and leadership, and how to finance the model within a public, managed care behavioral health system.