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Roche AI, Savitz ST, Kelpin SS, Lebow J, Lombardi N, Bogucki OE, Kurtzhals AA, Drews MS, Trane ST, Allen JS, Williams MD, Sawchuk CN. Study What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service. Ann Fam Med 2023; 21:S49-S55. [PMID: 36849471 PMCID: PMC9970678 DOI: 10.1370/afm.2927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/12/2022] [Accepted: 10/27/2022] [Indexed: 03/01/2023] Open
Abstract
PURPOSE Many individuals with behavioral health challenges receive services in primary care, and integrated behavioral health (IBH) programs can help increase access to evidence-based interventions. IBH programs can benefit substantially from integrating standardized tracking databases that allow for the implementation of measurement-based care to evaluate patient-, clinician-, and practice-level outcomes. We describe the development and integration of Mayo Clinic's pediatric and adult primary care psychotherapy tracking database. METHODS IBH practice leaders directed the development of a large psychotherapy tracking database that continuously populates from Mayo Clinic's electronic health record system. The database captures numerous patient variables including demographics, behavioral health and substance use issues, psychotherapy principles used, and self-reported symptoms. We retrieved current data for patients empaneled in Mayo Clinic's pediatric and adult primary care psychotherapy programs from June 2014 to June 2022. RESULTS The tracking database contained data for 16,923 adult patients and 6,298 pediatric patients. The mean age of adult patients was 43.2 years (SD 18.3), 88.1% were non-Latine White, and 66.7% identified as female. The mean age of pediatric patients was 11.6 years (SD 4.2), 82.5% were non-Latine White, and 56.9% identified as female. We provide examples of practical applications of the database across clinical, educational, research, and administrative domains. CONCLUSIONS The development and integration of a psychotherapy tracking database supports clinician communication, examination of patient outcomes, practice quality improvement efforts, and clinically relevant research. Our description of Mayo Clinic's IBH database may serve as a model for other IBH practices.
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Affiliation(s)
- Anne I Roche
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Samuel T Savitz
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.,Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota
| | - Sydney S Kelpin
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Jocelyn Lebow
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.,Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Nathaniel Lombardi
- Division of Integrated Behavioral Health, Mayo Clinic Health System, Albert Lea, Minnesota
| | - Olivia E Bogucki
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Maureen S Drews
- Research Application Solutions, Mayo Clinic, Rochester, Minnesota
| | - Sarah T Trane
- Division of Integrated Behavioral Health, Mayo Clinic Health System, La Crosse, Wisconsin
| | - Jay-Sheree Allen
- Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mark D Williams
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Craig N Sawchuk
- Division of Integrated Behavioral Health, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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Bogucki OE, Mattson AB, Leasure WB, Berg SL, Mulholland HL, Sawchuk CN. Adaptations of an Integrated Behavioral Health Program During COVID-19. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:481-491. [PMID: 33776398 PMCID: PMC7983459 DOI: 10.1016/j.cbpra.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/18/2021] [Indexed: 11/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has consistently been described as an "unprecedented" global health crisis. While the focus has been primarily on the medical and economic impact of the pandemic, psychological sequelae are anticipated. Primary care is the main point of access for mental health care in the United States, making it the ideal locale to provide psychological services for a larger proportion of the population than traditional mental health care settings. The aim of this paper is to describe how our multi-state, multi-site integrated primary care program adapted and applied cognitive behavioral therapy in the context of COVID-19. Access to mental health care was disrupted despite burgeoning mental health concerns, necessitating novel approaches to providing care. A stepped-care approach was implemented within our primary care practice, which consisted of a combination of low-intensity, high-yield stress management and resiliency building resources and cognitive behavioral therapy that were delivered flexibly based on patient preference, technological capabilities, state ordinances, insurance coverage, and institutional policies. The lessons learned from this experience can inform other integrated primary care clinics in responding to the current and future pandemics.
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Affiliation(s)
- Olivia E Bogucki
- Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN
| | - Angela B Mattson
- Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN
| | - William B Leasure
- Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN
| | - Summer L Berg
- Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN
| | | | - Craig N Sawchuk
- Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN
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Abstract
PURPOSE OF REVIEW This review discusses the role of the patient-centered medical home (PCMH) in treating depression, focusing on findings from primary care-based studies and their implications for the PCMH. RECENT FINDINGS Pharmacotherapy, psychotherapy, and collaborative care are evidence-based treatments for depression that can be delivered in primary care and extended to diverse populations. Recent research aligns with the core components of the PCMH model. The core components of the PCMH are critical elements of depression treatment. Comprehensive care within the PCMH addresses medical and behavioral health concerns, including depression. Psychiatric and psychological care must be flexibly delivered so services remain accessible yet patient-centered. To ensure the quality and safety of treatment, depression symptoms must be consistently monitored. Coordination within and occasionally outside of the PCMH is needed to ensure patients receive the appropriate level of care. More research is needed to empirically evaluate depression treatment within the PCMH.
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Williams MD, Katzelnick DJ. Advances in Collaborative Care. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2017; 15:243. [PMID: 31975853 PMCID: PMC6519561 DOI: 10.1176/appi.focus.20170025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark D Williams
- Dr. Williams and Dr. Katzelnick are with the Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - David J Katzelnick
- Dr. Williams and Dr. Katzelnick are with the Departments of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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