Behavioral Health – Primary Care Integration Partnerships: Maintain Pacing, Flexibility, and Capacity

This is the third in a series addressing key points in building a successful behavioral health – primary care partnership, adapted from “Strategies to Preserve Public-Private Partnership ‘Best Practices’: Keys to Genuine Collaboration” by Greg Schmieg and Bob Climko, MD, Behavioral Health Management May/June 1998. Vol. 18 . No. 3, in this and future posts.

Maintain Pacing, Flexibility, and Capacity

As with most exciting initiatives, there is considerable energy and excitement at the onset of a partnership between behavioral health and primary care organizations for integrated services. Unfortunately, the momentum can drop when the initial excitement succumbs to challenges and roadblocks that delay the results we anticipate. Therefore, this important step should be considered early on. There WILL be challenges to deal with: it’s inevitable. Preparing for this on the frontend will help to prevent disillusionment later on. Remember that the flywheel requires SIGNIFICANT front-loaded energy. So be sure to temper expectations. Early successes are important upon which to build. It helps to make it through the slow periods. Be sure to celebrate ALL successes to fuel enthusiasm and perseverance.

Ongoing communication focused on progress (or lack thereof) toward goals will help to keep everyone on track. Setting aside time to discuss successes and disappointments on a regular basis keeps the team focused. It can be so discouraging when things don’t work out as we had hoped. Taking time to process a disappointment provides the opportunity for several important things to happen: strengthening bonds through shared experiences, recalibrating the project, and finding the gold nuggets of success buried within the disappointment. 

It’s important to ensure that the team is clear on what the goals are. All parties should have an active role in establishing the goals. It’s not uncommon for behavioral health staff and primary care staff to have different objectives leading to the goals. Taking the time to clarify objectives promotes mutual respect and strengthens the relationship further.

As the natural differences between the cultures of the partners emerge, a balance must be achieved between pushing and pulling. Too much coaxing creates resentment, as does the feeling of always having to compromise on expectations. While no one wins all the time, each partner should feel that a few wins have been negotiated. Taking the time to reach a compromise that respects each partner will strengthen the relationship.

While following established timelines and schedules are important, excessive rigidity creates a chasm between partners. Flexibility and sensitivity to capacity issues are critical to the success of the partnership. Don’t forget that reality happens!

Next we will explore the importance of developing shared solutions for a successful behavioral health – primary care partnership.