Caring for the Whole Person – Behavioral Health in Community Health Centers
National Health Center Week 2020
Each year, more than 28 million individuals receive care in community health centers like Wheeler...one in 12 Americans! The complete, whole-person care delivered by health centers improves health outcomes and addresses some of the most pressing issues in health care today like: access to affordable care; treatment for substance use disorders and chronic diseases like diabetes, high blood pressure; equity and injustice; and much more.
Behavioral health is a historic core service in Wheeler’s continuum of care, and we asked Vice President of Family Health & Wellness Center Outpatient Services, Teodoro Anderson Diaz, LCSW, LADC, how behavioral health is integrated in Wheeler’s community health centers.
We hear about integration of primary and behavioral health. What does that mean to a patient?
Wheeler was an early leader, 20 years ago, in recognizing that primary care and behavioral health care are not only connected but bound. You can’t address wellness without an integrated approach to care. I think we’re a bit unusual in that we have such a strong history of effective behavioral health since 1968, adding in primary care in the last decade, versus the other way around as in many other organizations. That high-level philosophy shapes everything we do.
On a real, practical level, day to day, it means a patient experiences shoulder-to-shoulder teamwork from our entire staff the moment they come in for care. Our behavioral health clinicians sit next to and with primary care providers, are peers and equals, and the entire team reviews patient plans of care together. A patient may come in for a back pain, for example, and the treating medical staff can immediately bring in behavioral health staff if there is, perhaps, effective ways we can treat underlying or related conditions like depression that prevent wellness. Integration means we’re looking at the whole person, together.
Talk about the role community health centers play in addressing the opioid crisis.
Addiction affects every household in the country, every community, every city or town. It does not discriminate. The National Association of Community Health Centers reports a fivefold increase in patients seeking treatment for opioids and other substance use disorders since 2010, and that’s very much in line with what we’ve experienced.
Because of the unique way Wheeler delivers care in our health centers, patients with substance use disorders receive a seamless continuum of services. We address access to life-saving treatments like NARCAN right at intake, thanks to on-site pharmacies. We quickly and effectively provide individual and group therapies delivered in-person and via telehealth. Medication-assisted treatment (MAT) combines behavioral therapy and medications to treat substance use disorders, and is an effective, evidence-based treatment. MAT has dramatically improved the path to recovery for many, many people. It's a game-changer in many ways, especially when offered with a strong peer recovery support system like we have.
When you integrate substance use disorder care right with primary care, in one setting, with supports, you’re truly offering patients the best approach to help them in their recovery.
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How do community health centers address health equity in behavioral health?
We believe everyone has a right to quality behavioral health treatment regardless of race, ethnicity, gender, socioeconomic status, or sexual orientation. But it is far deeper than that; it’s an obligation to address and provide culturally responsive care every day for our communities. From their creation 50 years ago, health centers have been vital players in addressing profound and systemic injustice in our health care system. We often care for marginalized and disadvantaged populations who have traumatic and everyday struggles with the social determinants of health, such as employment, racism, education, housing stability, insurance status, transportation, education, and more. These all have an impact on behavioral health outcomes. Community health centers are leading the fight for health equity, and have since the beginning.
RELATED ARTICLE: Our Work To Do.