UCHealth is rolling out a model of doing business that places a behavioral health specialist in all 60 of its primary health care clinics statewide.
Under the new system, after seeing their regular doctor, existing patients with symptoms of anxiety, depression, bipolarism, PTSD, schizophrenia, psychosis or other mental imbalances can immediately book an appointment and within days receive mental health care in the same office.
“It’s a relief to patients to be able to address these concerns in an expedited manner,” said Lynnay Carona, a licensed clinical social worker who works with doctors at the UCHealth primary care clinic on East Fontanero Street in Colorado Springs.
Carona was among the first behavioral health specialists hired to undertake a pilot program that launched in February at three UCHealth clinics on Colorado's Front Range.
The idea now has been elevated to a full-fledged program, as part of a $100 million plan to improve behavioral health services that UCHealth announced last year. The Aurora-based nonprofit medical system operates 12 hospitals, along with clinics, labs and other services in Colorado, Wyoming and Nebraska.
“Unfortunately, because of the fractured nature of behavioral health care delivery, to find a provider, get in touch with them and get scheduled can take a long time,” Carona said. With the new program, “We can see them the next day. This is a whole new world,” she said.
But it’s not a new concept.
Penrose-St. Francis Health Services, a part of Centura Health, another nonprofit healthcare system in Colorado, has been integrating behavioral health specialists into primary care offices for years, said Dr. Di Thompson, medical director of behavioral health for Penrose-St. Francis Health Services. Primary care centers have on-site mental health specialists who work with patients not only on mental conditions but also health aspirations such as losing weight and quitting smoking, she said.
As a psychiatrist, Thompson consults with the behavioral health staff on cases, and ongoing mental health needs can be met at two Penrose-St. Francis general behavioral health clinics in Colorado Springs and another in Monument, along with a drug-and-alcohol treatment center in Colorado Springs.
In working alongside medical doctors, the focus is on treating both the mind and the body, Carona said, because mental health is closely tied to physical health. Patients also can learn coping skills for managing chronic diseases such as high blood pressure and diabetes for example.
“Diabetes is very often co-morbid with depression — they feed off of each other,” Carona said.
Because the behavioral health appointments are handled through the primary care physician, patients are charged the same copay as a regular doctor visit and the number of visits isn't limited by insurance, she added.
“We love this approach,” said Kirk Woundy, associate executive director of the Colorado Springs office of the National Alliance on Mental Illness. “It removes a number of barriers to care — the services are available in a familiar and accessible place, without the weeks-long wait times that people often encounter as a new patient somewhere else.”
The network's behavioral health specialists also consult with a psychiatrist on cases, and patients can receive advanced counseling and expertise from them about medications, a feature Carona said makes the program more valuable.
“Psychiatric access is really difficult to come by in Colorado,” she said.
Gov. Jared Polis last month approved recommendations for statewide reform for behavioral health care that includes establishing a new state agency to oversee the system, which has been defined as failing to meet people's needs.
UCHealth's expansion comes at a time when the number of people experiencing mental health conditions is increasing due to the uncertainty, loneliness, disconnectedness and stress of the coronavirus pandemic, experts said.
Polling conducted by the Colorado Health Foundation has shown that more than half of Coloradans — and nearly two-third of the state's poorest residents — are dealing with greater mental health strain as a result of COVID-19.
“As the pandemic stretches on, the mental health impacts are intensifying,” Woundy said in an email. “We're seeing it among those we serve and even among some of our longtime volunteers.”
Cases of anxiety and depression are spiking locally, Carona said, and being exacerbated by the isolation coming from quarantine measures.
UCHealth has hired behavioral health specialists for 30 of its primary care clinics, including in Colorado Springs and Woodland Park, with full integration expected over the next few years, said Elicia Bunch, vice president of behavioral health for UCHealth.
In addition to increasing availability of care, the program is designed to reduce the stigma often associated with mental health as “lack of access and stigma continue to be barriers to care," she said.
Providing a whole-person approach in advocating for good physical and mental needs reduces the stigma, Bunch said, by “normalizing access and care.”
Said Carona: “It’s been a long time coming.”