Presenters
- Elizabeth A. Allan, MD, Clinical Assistant Professor, Department of Child and Adolescent Psychiatry at NYU Grossman School of Medicine, Brooklyn, NY
- Jon Marrelli, PsyD, Program Manager, Behavioral Health and Primary Care Integration and Clinical Assistant Professor, Department of Psychiatry, Family Health Centers at NYU Langone Sunset Terrace, Brooklyn, NY
Summary
The Collaborative Care Model is a widely-used system of behavioral health delivery, in which behavioral health services are delivered in a team-based approach using principles of chronic disease management. Its evidence base was first developed among individuals with depression, but Collaborative Care’s reach has expanded over the past 25 years to address a variety of chronic psychiatric diagnoses across clinic settings, including rural and urban Federally Qualified Health Centers (FQHCs). Founded in 1967 in Brooklyn, the Family Health Centers at NYU Langone is one of the oldest community health centers in the US, and is now one of the largest FQHC networks in the country. In recent years, the behavioral health needs of its clients were met through a combination of specialty psychiatric services and integrated care within the primary medical clinics. In 2019, the Family Health Centers began to transition integrated behavioral health care toward the Collaborative Care Model. This presentation examines the first 20 months of Collaborative Care program implementation, a period of time that encompasses the COVID-19 pandemic and a renewed focus on racial justice. We present a timeline of implementation, paired with data from our electronic medical record, to show how use of the Collaborative Care Model via a telehealth platform during the pandemic allowed our health system to absorb increased referrals, expand patient access, and continue to meet the needs of a community greatly impacted by COVID-19 in NYC. We examine strengths of our program implementation, which include increased identification and referrals by primary care physicians, increased patient diagnoses and treatment through telemedicine, and success in delivering culturally appropriate services to patients in Spanish. We also describe challenges in bridging the digital divide and in scaling up to rapidly meet need.
Objectives
- Identify three key variables that distinguish the Collaborative Care Model from co-located Integrated Care
- Provide two examples of how Collaborative Care Model can more effectively meet the behavioral health needs of underserved patients in an urban FQHC
- Describe two major barriers to Collaborative Care Model implementation when services are delivered through telehealth
