>>DAN MULLIN: So the Barre Health Center has been here in the community for more than 40
years now.
It is a rural community at least by Massachusetts standards.
Our patients prefer to get their care with us rather than going into the big city whenever
possible.
Unfortunately, it is a pretty good drive to any of the local mental health centers.
>>STEPHEN EARLS: We provide care for everything from prenatal care to end of life care and
everything in between.
Because of the community we are serving and the fact that we are in a community with no
emergency room nearby we also have a robust urgent care function.
Within family medicine a large percentage of patients come in with “medical” problems
that have a large behavioral health component.
>>DAN MULLIN: In the leading ten causes of mortality for example pretty clearly eight
or nine of those are tied directly to behavior.
Behavior is the thing that leads people to get sick or once they get sick they need to
begin to modify their behavior in order to improve the outcome
>>RECEPTIONIST: Good Morning Barre Health Center.
This is Carol.
>>DAN MULLIN: Family physicians in particular tend to be very open to having psychologists
on the team.
I find myself in a lot of really important ways being treated as an equal.
I’m a member of the same physician group that they are, I receive the same benefits.
I’m in the same meetings.
I’m involved in making the same decisions.
There is a real opportunities for psychologists to be treated as equals when they come in
to the primary care settings.
>>K. AHMED HUSSAIN: It’s not like there is the group of family physicians and then
there’s...
>>ALEXA CONNELL: Me as an add on.
Yeah.
>>K. AHMED HUSSAIN: She is a part of the meetings every month.
She does contribute.
And anything behavioral health is channeled through Dr. Connell.
It doesn’t have to be an emergency or a significant illness.
Sometimes it could be somebody who is going through a slump and just needs counseling.
>>STEPHEN EARLS: Life is a struggle for a lot of people.
And the more support we can give them the better they do with their life, the better
they do with their chronic disease management, and the better engaged they are.
Having that resource available just makes that so much easier.
It makes us more efficient and provides them with a better level of care.
>>PATIENT: This has been my provider for over 20 years.
I know the care that I get here.
And I trusted it knowing that it was someone here and that I didn’t have to go into the
city or start with someone new.
>>DAN MULLIN: When a physician has a patient walk in and the physician identifies them
as someone with an unmet mental health need or substance abuse need they can come knock
on my door or call me on the phone and ask me to step in.
>>ALEXANDER BLOUNT: One of the benefits is being able to address things while they are
a concern.
While people are ready to make a move.
When you raise something with your physician and you say “this is really hard.
I don’t know what to do about it or I’m really struggling” the chance to do something
about it is best at that moment.
And the chance goes down over time.
>>STEPHEN EARLS: Patients come into our health center and you can’t tell looking at our
patients in the waiting room who is here to see whom.
They might be here to see a doctor, they might be here to see a psychologist.
They are not going to a different building for their mental health needs and their physical
health needs.
The stigma goes completely away.
>>DAN MULLINS: Being able to hand-off to a psychologist on the team who can maybe spend
a little bit longer with them or help build on what they are doing with the physician
can help the physician get to their next patient.
>>ALEXA CONNELL: We raise each other’s skill set.
I learn more about medicine every day.
You learn more about mental health every day.
It’s enhancing both of our skill sets.
>>TINA RUNYAN: I fell in love with primary care very early in my career as a psychologist.
We’re moving much closer to how people experience their own health and wellness as well as their
own disease processes.
It’s more than just the technique of how to deliver care in this way but conceptually
how to get everybody on board working as a team to take care of people in this way.
What’s available to me to understand the person sitting across from me is so much more
extensive in terms of having their medical record.
You have so much more context and you have a team to work with.
>>ALAN BROWN: A lot of our work is pretty isolative so to be able to share notes and
share ideas and learning is bidirectional.
>>STEPHEN EARLS: We can see each other’s notes.
We can communicate within the record through a task or a note pretty readily.
>>ALEXA CONNELL: We can make sure the patient is getting a consistent message from their
two primary longitude providers that you can’t get if you’re not integrated.
>> K. AHMED HUSSAIN: When you look at the value proposition it saves you money in terms
of better outcomes, in terms of less ED visits, less hospitalizations
>>STEPHEN EARLS: I think we provide great care in our practice and I think having behavioral
health readily available is a big component of that.
>> K. AHMED HUSSAIN: Good primary care is good primary care and integrated primary care
is really good primary care.