Presenters
- Stacey Ouellette, LCSW, Director of Behavioral Health Integration, Maine Behavioral Healthcare, Portland, ME
- Amy Mayhew, MD, MPH, Clinical Director, Maine Medical Center Department of Psychiatry, Portland, ME
- Julie Carroll, MPH, Project Manager, Maine Medical Center, Portland, ME
Summary
The environment created by the pandemic has caused strained and created inexplicable hardship. The rise of mental health concerns has created a second pandemic. Kids Count Data in Maine for 2021 indicates 20.2% of Maine children ages 0-17 reported >2 ACEs, teen depression rates are hovering around 16.1% and 16.5% of children ages 3-17 are experiencing anxiety. Child and teen suicide rate is at 8.5 per 100,000 deaths, putting us above the national average of 6.6. Demand for psychiatry has never been higher and, despite the tremendous need, shortages continue to exist, especially for rural and medically underserved populations. MaineHealth is working to address these gaps in psychiatric care by building an infrastructure of consultative support for primary care providers. Our goal is to enhance care, reduce burnout of primary care by providing timely support, and improve the health and wellbeing of our patients. One strategy was creating the Psychiatry and Primary Care Partnership (PPCP) for our system. The partnerships break down walls to allow primary care providers access to psychiatry when treatment regimens are proving uncertain. PCPs can message the psychiatry partner via the electronic health record (Epic) to ask questions and receive answers quickly. This also includes lunch and learns to further the PCPs knowledge and skill set around managing psychiatric conditions. When the pandemic hit, additional access to psychiatric support was vital in order to meet the rising demand of mental health in our pediatric population. The Child Health Access HRSA grant has provided funding for staffing to implement and coordinate synchronous consultations between a PCP and psychiatric provider. These consultations occur via Zoom and average thirty minutes. The grant allows dedicated time for training primary care teams in recognizing and treating an array of psychiatric conditions. A twelve week educational series on various topics was developed and made available to all providers in the state. E-Consults were the next option to be developed. These consultations include a review of the medical record, documentation in the medical record, patient consent, and patient co-pay. This approach allows for reimbursement and ultimately sustainability, documented recommendations, and increased psychiatry access for patients. Implementing the Collaborative Care Model is our next goal. We have several projects underway to move us towards this. We are currently funding consultative services from the AIMS Center to learn from their expertise as we develop our next option in psychiatric support to our colleagues in primary care. These consultative options for psychiatry, both synchronous and asynchronous, are beginning to provide the much needed respite and care necessary to assist our primary care colleagues in rendering the best care. While there remains a long road ahead, together we can make a difference in caring for patients.
Objectives
- Learn about models psychiatry consultation.
- To identify the benefits and challenges of implementing psychiatric consultations within a larger healthcare system.
- Begin to customize ones own approach to creating psychiatric consultation services within their own healthcare system.
