A09 – Physicians, Owls, and Access to Behavioral Health: Interdisciplinary Teamwork

Summary

A goal of integrating pediatric behavioral health into primary care is to increase access to care. Integrated behavioral health clinicians are in the unique position to complete warm hand offs (WHO), which is when the trusted medical provider introduces the patient to the behavioral health clinician during the medical appointment. WHOs allow for same-day services and/or scheduling follow-up behavioral health appointments. Some early studies found no additional benefits of completing a WHO (Pace et al., 2018), while more recent studies found improved follow-up rates (German et al., 2020; Gurney et al., 2020; Mitchell et al., 2022) and a reduction in time until behavioral health encounters (Young et al., 2020). The goal of the current study was to use a pre-post design to evaluate the differences in time-to-be-seen and patient/family engagement metrics within a family medicine clinic following the implementation of a monthly presentation regarding the impact of WHOs on patient’s behavioral health care. The presentation included feedback regarding the WHO procedures, frequency of WHOs, common presenting concerns, and outcomes of WHOs. Additionally, behavioral health clinicians presented the provider with the most collaborations for the month with an owl pendant. Prior to the intervention, the average time to be seen within the clinic was 42 days. Time-to-be seen for the three months following the intervention were 16, 8, and 5 days, respectively. Additional benefits of WHOs included same-day behavioral health services (n = 10), including crisis evaluations, safety planning, and brief behavioral management strategies, which were provided for 28% of WHOs. Primary care providers described the presentation as helpful for understanding the impact of WHOs vs. referral-based care. Overall, the preliminary data show that in a busy family medicine clinic, providers are more likely to facilitate a WHO instead of placing a referral following continuous feedback. Importantly, WHOs increase patient engagement in behavioral health services and reduce time-to-be-seen.