It’s no surprise that mental and physical health are connected. Like peanut butter and jelly. The sun and the moon. A pen and a piece of paper. One directly influences the other. What might be surprising, though, is that, despite their obvious connection, mental and behavioral health are often treated in separate clinics by separate providers at separate times. Why not treat patients for both in the same place? Enter integrated behavioral health.
Dr. Huda Sheraf, Medical Director for the Pat Walker Health Center at the University of Arkansas at Fayetteville, recently went on an episode of AFMC TV to discuss U of A’s integrated behavioral health model that offers a blend of primary and behavioral health care services to the campus’s students, faculty, and staff.
What is integrated behavioral health?
“Integrated behavioral health, or IBH, is a model that blends into primary care. It is a mental health resource typically housed in a primary care clinic meant to offer accessible (sometimes same day) mental health intervention,” Dr. Sheraf says.
This model is important because it takes care of the whole person in one place, where patients receive a collaborative plan covering their physical and mental health. “This allows for more timely and productive visits and increases access to mental health services that some may not have,” Dr. Sheraf says.
In primary care settings, mental health diagnosis is very common. One in eight adults in the U.S. are diagnosed with some form of depression each year. And that doesn’t even account for those who go undiagnosed for a litany of reasons. “Depression, anxiety, and insomnia are among the top 10 diagnoses we see in primary care,” Dr. Sheraf explains. “It made sense for us to start this program eight years ago.”
The Pat Walker Health Center
Opened in the fall of 2015, the Pat Walker Health Center was one of the few resources in the country, if not the only resource, that offered IBH to their campus community. “That’s changed,” Dr. Sheraf adds. “The push for this resource has become more popular over the years. People have become more receptive to these types of programs on college campuses.”
The Pat Walker Health Center is available to all students, faculty, and staff at the U of A. The University of Arkansas is uniquely positioned to offer an IBH program due to the strong support of Dr. Ana Bridges, a faculty member who helped build and pilot the program. “This was a new thing for the majority of us who started the program,” Dr. Sheraf says. “Because of Dr. Bridges’ experience as a psychologist, she was our resource and guide through the whole process.”
“Our IBH program is unique in that it’s a resource staffed by psychology interns at the U of A who are interested in pursuing IBH as a career. With Dr. Bridges’ help, we were able to have them work in our facility,” Dr. Sheraf said.
Despite the support, however, the program was not without its challenges. “At the beginning, we had one student working 16 hours of IBH per week,” Dr. Sheraf explained. “That one student would be booked for two to three weeks, and that went against our model of same-day service and handoff to a professional psychologist in a clinical setting.”
Thankfully, as more grad students and psychologists became interested, the IBH program at the U of A has grown, allowing more grad students to work and offering more availability to the campus community.
Depression rates have been on the rise post-COVID.
Depression is not exclusive to one age group. Anyone, from first-year students to grad students, teaching assistants to tenured faculty members, can suffer from depression. “COVID took a toll on everyone,” Dr. Sheraf said. “Students were so isolated. The way they went to school and socialized changed so quickly. Faculty switched overnight from in-person to online teaching. There’s a lot of stress that goes with those sudden shifts.”
As the entire world continues to see the long-term effects COVID has had on our mental health and overall social well-being, integrated programs like these are such a valuable resource. Life, in general, is stressful. “Even independent from COVID, we’ve seen an increased number of people that present to our clinic with mental health issues,” Dr. Sheraf says. “This is not unique to our clinic.” A resource that combines mental and physical healthcare services in one place is an absolute game-changer.
The ultimate goal is a quick intervention resource.
“The counselors who work within our model are behavioral health consultants, which we thought was a more receptive name than a ‘mental health counselor,’” Dr. Sheraf added.
“Our goal is not to replace professional mental healthcare or counseling. The goal is to offer an immediate, quick behavioral intervention that results in a positive improvement in a person’s mental health.” The visits only last 30 minutes and are not meant to be a long-term option for any individual.
“As medical providers, we need to be able to refer the right people for IBH programs. Some people may benefit from a behavioral health clinic that offers more than what our model offers,” Dr. Sheraf said. What’s important, however, is that the resource is there for those who need it.
Mental health services across the country are extremely limited. “It’s hard enough to get someone connected to a center that offers long-term, individualized counseling, much less a program like ours,” Dr. Sheraf said. “We’re lucky enough to start this on a campus with a psychology department, a leader and faculty member with expertise in this model, and staff interested in learning more about it. Ultimately, our long-term goal is to have a behavioral health consultant hired full-time.”
The Pat Walker Health Center is a fantastic asset to the community because it establishes a comprehensive approach to healthcare. “With integrated services, you address all the issues. If you improve mental health, the physical health symptoms also get better,” Dr. Sheraf explained. “Sometimes, we may not see the whole picture with a patient and look at their physical and mental needs. If we don’t do that, it can cause long-term frustration for patients who have symptoms that aren’t improving.”
Mental and physical health go hand-in-hand. Despite sometimes being treated separately, the medical community is beginning to learn the benefits of integrating behavioral health services into primary care settings. Integrated models allow providers to offer a collaborative, whole-person approach to treatment that truly makes a difference in the lives of the 21 million adults and counting who are affected by depression.
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