Integrated Care Track at IPS Looks at Expanding Model to New Settings

This year’s integrated care track at IPS: The Mental Health Services Conference will include some of the tested favorite courses and workshops that members have come to expect of the track, along with some new learning experiences on how the collaborative care model can be adapted to diverse settings.

“We will be offering many of the same themes seen in previous years including sessions on behavioral health homes and early mortality in the SMI population, but we will also be looking at new ways to offer integrated care,” said Scientific Program Chair Lori Raney, M.D., who is also chair of the APA Work Group on Integrated Care. “We know the collaborative care model works, but not everyone has the resources or the staffing necessary to fit the standard model of collaborative care. So we hope at the IPS to go another layer deeper and look at how we can use technology, task sharing, blended models, and other adaptations to bring the model to diverse settings.”

Importantly, IPS will be the site of two training sessions in integrated care offered through the Centers for Medicare and Medicaid Services’ (CMS) Transforming Clinical Practice Initiative (TCPI). (Three training courses were offered at the 2016 Annual Meeting in Atlanta.)

Through the TCPI, APA is receiving a $2.9 million, four-year federal grant from CMS. APA is one of just 39 organizations that was chosen to participate in the TCPI; as one of the Support and Alignment Networks (SANs) awarded under the grant, APA is committed to training 3,500 psychiatrists in the principles and practice of collaborative care, a specific model of integrated care developed by the late Wayne Katon, M.D., Jürgen Unützer, M.D., M.P.H., and colleagues at the AIMS (Advancing Integrated Mental Health Solutions) Center at the University of Washington.

The course being offered at the IPS is “Integrating Behavioral Health and Primary Care: Practical Skills for the Consulting Psychiatrist.” The training will be offered twice on Saturday, October 8: from 8 a.m. to noon and again from 1 p.m. to 5 p.m. Participants will be seated on a first-come, first-served basis.

The course is designed to make the case for integrated behavioral health services in primary care, including the evidence for collaborative care; discuss principles of integrated behavioral health care; describe the roles for a primary care consulting psychiatrist in an integrated care team; and apply a primary care–oriented approach to psychiatric consultation for common behavioral health presentations.

The course will also educate psychiatrists on how to engage in TCPI and connect with primary care networks in their regions that are recruiting psychiatrists with integrated care training.

Speakers include Raney; Erik Vanderlip, M.D., M.P.H., a physician dually trained in family medicine and psychiatry and coauthor of a recent APA resource document on integrated care; and Anna Ratzliff, M.D., Ph.D., and Lydia Chwastiak, M.D., of the AIMS Center. They will present didactic material, facilitate group exercises, and include time for questions and discussion.

Apart from the TCPI training, APA will offer multiple workshops, lectures, and alternative learning experiences throughout the conference. Raney drew special attention to sessions that focus on using technology, including telepsychiatry, to expand the scope of integrated care

On Thursday morning, October 6, Ratzliff and colleagues from the University of Washington will discuss residency training in integrated care during the session “Building an Integrated Care Training Program.”

Later that day, physicians from the American Association of Community Psychiatrists will present the session “Integrated Care and the Role of the Community Psychiatry Fellowship.” And Vanderlip, Ratzliff, and Chwastiak will lead the innovative “Collaborative Care Simulation Lab,” in which participants will use case vignettes to role play the care of patients in a collaborative care system.

On Friday, October 7, experiences in integrated care in diverse parts of the country will be addressed in the session “Community Clinics on the Continuum of Integrated Care: Lessons Learned in Cleveland, Miami, and New York City.” Alternative models of integrated care will be investigated in the sessions “Collaborative Care: One Size Doesn’t Fit All” and “Care Coordination for Behavioral Health Problems in Primary Care Settings: How Far Can We Stretch This Approach?”

Also on Friday, Vanderlip will lead the perennially popular course on primary care skills for psychiatrists.

Saturday, October 8, is reserved for the TCPI training, and on Sunday, October 9, integrated care goes international when Unützer and colleagues lead the symposium “Challenges and Opportunities in Implementing Collaborative Mental Health Care in Low- and Middle-Income Countries.”

Also on Sunday, Benjamin Druss, M.D., and colleagues will look at emerging models of integrated care and the role psychiatrists can play in addressing the 20- to 30-year mortality gap among those with serious mental illness.

“We are offering the standards in integrated care, but we hope to provide conference participants this year other options for expansion and implementation,” Raney said. “How far can we push this model of collaborative care by really thinking outside of the box?” ■