What We Do » Integrated Primary Care and Behavioral Healthcare
The Integrated Treatment Tool (ITT), is a planning and evaluation instrument that enables organizations to implement integrated primary and behavioral healthcare services systematically for people with serious mental illness. The tool consists of the following:
This tool is to evaluate the presence and extent of a Person-Centered Healthcare Home Model that integrates primary and behavioral healthcare services. The target population for this model is the grossly underserved group of people who meet criteria for severe and persistent mental health conditions who may have any range of primary and/or behavioral health care needs. An integrated holistic approach to care requires a structured approach to the coordination of all aspects of a patient’s life (including behavioral, physical, and spiritual health in addition to basic needs of safety, security, and social/sense of belonging). The goal of this approach is to increase health outcomes, improve quality of life, and decrease fragmentation of care.
While the platform for the model is the concept of a “Medical” or “Healthcare Home,” there are several areas that needed to be added or adapted to meet the needs of people who meet criteria for severe and persistent mental health conditions. As evidenced by the fact that people who meet criteria for severe and persistent mental health conditions die on average 25 years younger than their non-ill counterparts, existing approaches have not been effective with this population.
- Person-centered- Multi-disciplinary health care team
- Recovery focused - Stage-based and motivational
- Holistic - Stepped care
- Integrated approach(integration of the three domains of care: mental health, substance related, and other medical conditions)
– care within and among these domains is well coordinated
An integrated approach addresses not only the needs that fall within the larger domains of care – mental illness, substance use (including tobacco), and other medical conditions – but addresses how each of these conditions and their treatment impacts the other conditions and treatment. An integrated approach occurs when all clinicians are well trained in mental health, substance use (including tobacco), and other health conditions and the interactions among the conditions and their treatments. In addition to training, their individual interventions are based on the knowledge of the whole person, his/her goals and readiness to address behavior change, what conditions and treatments are present, and address the interaction of each of these domains on the others. This tool is separated into three sections to highlight the need for attention to these distinct aspects of implementing an integrated approach to care for this population.
Section I. Organizational Characteristics – the structural aspects of implementation.
Section II. Treatment Characteristics – the clinical components of implementation. It is important to pay attention to the presence as well as the quality of services and interventions employed.
Section III. Care Coordination/Management Characteristics – a critical aspect to an integrated approach. Care coordination/management is a set of activities designed to increase access, improve health-related outcomes, and decrease fragmentation of care.
The tool was developed incorporating the best available evidence – combining theoretical, empirical, and practice based knowledge. It is important to note that while several models that address pieces and components of this tool exist, the combined model/approach does not rise to the level of an evidence based practice. While each element presents gradations toward a theoretical ideal (rating of 5 based on a continuum of 1 through 5), it is possible that “lower” levels within an element may be sufficient to produce significant results.
Consulting services are available to support your organization with implementation of integrated primary and behavioral healthcare services.