How Behavioral Health Integration Improves Access to Mental Health for Underserved Communities

By Dr. Christina Abby, Clinical Programs Manager

Early in life, I believed that all people had a certain superpower.

My superpowers, listening to and helping others, not only came natural to me but made me feel special, empowered, and impactful.

This became clearer in 9^th grade when a class project required me to answer the hardest question you can ask a teenager: what do you want to be when you grow up and what path do you need to take to get there? A lot of pressure to ask someone at 14 but easy for me: I wanted to leverage listening for good, and from that day on, I knew I wanted to make an impact in mental health.

Now, a Clinical Programs Manager for evolvedMD, that dream became a reality but the journey to this point was not easy.

My mother became terminally ill during my junior year of college, and by the time I graduated I was being counseled on her final care arrangements. This took a toll on me mentally. She made a miraculous turnaround and survived, but not without a serious battle to return to her somewhat normal self. Prior to this, during my sophomore year of college, I lost my best friend since Kindergarten/roommate in an unfortunate car accident. Several states away, my mom could tell over the phone that I wasn’t okay, prompting her to use the school’s directory and contact a professor that she heard me talk about frequently. My professor pulled me to the side to check in and encouraged me to be strong, to admit I wasn’t okay, and to not fight that alone. This further inspired me to work in the behavioral health field because not everyone is fortunate enough to have someone encourage or advocate for them, so why shouldn’t it be me? This is especially true for minority communities who struggle to access and receive high-quality behavioral health services.

Finding evolvedMD allowed me to get into an area that encompasses all the things that I enjoy but also allows me room to innovate and lead meaningful change. That’s why, in celebration of Black History Month, I am compelled to share information about behavioral health integration and how it can increase access to much-needed behavioral health services for minorities.

The Current State of Mental Health in America for Minorities

As an African American woman working in behavioral health, I’ve seen, firsthand, the incredible disparities for mental health in minority communities. Disturbing and oftentimes frustrating, these disparities and disadvantages exist for a number of reasons, the most common being cultural stigma and lack of access to services. This reality is especially harrowing given the following factors:

• Higher Prevalence – African American adults are more likely to experience feelings of sadness, hopelessness, and worthlessness than adult whites
• Lack of Access – Only one in three Black adults who need mental health care receive it
• Lower Quality – The care received is more likely to be poor in quality
• Inconsistency – African Americans are less likely to receive guideline consistent care

We owe these communities more: more access, more quality, more focus.

But what can clinicians, leaders, and organizations do to close the gap to quality care?

The Role of Behavioral Health Integration

From my vantage point, behavioral health integration – the practice of marrying physical health and behavioral health and focusing on whole-patient care – is the best solution. Particularly, Psychiatric Collaborative Care (CoCM), the “gold standard” of integration is the model I’ve seen drive the best outcomes, and at evolvedMD, where I serve as Clinical Programs Manager, we have enhanced CoCM to be more comprehensive and beyond collaborative, leading to a better experience for patients and providers.

Through the lens of the four factors driving disparities identified above, our approach to behavioral health integration can effectively and uniquely address each by:

• Developing and utilizing a culturally competent approach to behavioral health – Teaching a culturally competent curriculum to our therapists through ongoing, clinically validated trainings, Lunch and Learns, diversity and inclusion resources, and other initiatives helps them to better understand patients and their unique experiences. This helps therapists to deliver high-quality behavioral health services that can address symptoms unique to certain identities and experiences.
• Increasing access by meeting patients where they are and where they prefer care – Not knowing where or how to access services is a significant barrier that prevents many racial minorities from seeking help, but behavioral health integration enables providers to meet patients right where they are—at their PCP’s office. Embedding our clinicians onsite and in person (or virtual, if requested) at primary care practices ensures patients have immediate access to mental health services if referred by their PCP. Not to mention, offering behavioral health services in nontraditional settings such as a primary care practice will encourage participation. It’s cheaper, too. Through integration, patients pay the same copay as they would seeing their PCP, important to increasing access given the average cost of therapy in the U.S. can be upwards of $200 per session.
• Increase quality by deploying only master’s level, licensed providers -- Given the mental health provider shortage, it can be difficult for patients to find a mental health practitioner who can meet their needs. The quality may not be consistent either when referred elsewhere in the community. Staffing primary care practices with master’s level, licensed clinicians who receive consistent clinical training and supervision guarantees higher quality services and improved patient outcomes.
• Provide consistent care through the collaborative care model promoting whole-patient care which requires physical and behavioral health to co-create a consistent care plan – Each patient brings a complex set of symptoms, life experiences, and other circumstances that directly impact their physical, behavioral, and emotional health. Embedding masters level clinicians within a physician’s team not only streamlines communication but also enables healthcare providers to proactively address the whole patient before adverse symptoms become severe.

Actionable Tips for Healthcare Institutions to Better Serve Minorities

Promote and practice DEI initiatives
At evolvedMD, we work together to promote Diversity, Equity, and Inclusion initiatives to a build a more impactful culture. Teaching a culturally competent curriculum to our therapists during training, Lunch and Learns, and other initiatives is a big part of that. We’re also mindful about making a similar impact on our communities, too. Something I would like to see healthcare institutions do is build a more diverse behavioral health workforce that’s representative of the populations we serve. According to a study from the University of Michigan’s Behavioral Health Workforce Research Center, minority providers are more likely to meet the needs of underserved populations and that a diverse workforce leads to greater patient satisfaction. Building a diverse workforce won’t happen overnight, but what organizations can do now is better support their current minority workforce to retain talent and prevent burnout. In my experience, this looks like offering personal and professional development opportunities, promoting and practicing self-care and wellness, and regularly offering training programs to keep skills sharp with current trends.

Engage in advocacy and outreach to drive awareness
Increasing cultural competency is another way healthcare institutions can better serve minority communities. This looks like offering training to help providers understand the importance of culture, the different types of barriers to receiving treatment, and promoting equity within your organization. This also looks like disseminating critical information to drive awareness and educate your communities. For example, Mental Health America is chock-full of information and resources such as this infographic or their online screening tool to determine whether someone in your community is experiencing symptoms of a mental health condition.

Partner with a behavioral health integration leader
Behavioral health integration is critical to driving improved patient outcomes and increasing access to care for minority communities. By partnering with evolvedMD, a market leader in behavioral health integration, your primary care practice becomes a comprehensive solution and a champion of whole-body care. Since our founding in 2017, we have created meaningful change under the principle that patients are better served when primary care and behavioral health work together.

In honor of Black History Month, I hope this piece inspires healthcare institutions and leaders to take the necessary steps to better serve minority populations.

Learn more about evolvedMD’s unique approach to
increasing access to high-quality mental health services.