behavioral health integration

Behavioral Health – Primary Care Integration Partnerships: Delegate Trust

The delicate subject of trust is the focus of this installment in the series devoted to creating a healthy integrated partnership between behavioral health and primary care. This has been 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.
Trust is necessary to overcome expected conflict
When team members of the behavioral health and the primary care organizations come together for an integrated partnership, typically everyone is on their best behavior. It is easy to have a harmonious relationship at this stage. However, when conflict first intrudes, particularly regarding shared goals and outcomes, the amount of trust between partners can make or break the partnership. Create the forums at the onset to maintain a system of checks and balances. Face-to-face time creates a forum for maintaining checks and balances to ensure fidelity to the mission. Constantly solicit feedback from partners at all levels. The transparency also breeds trust.
Focus on building trust at all levels
It takes a significant amount of trust for a person to commit to any partnership; the behavioral health primary care integrated partnership is no different. Often the partnership is created when two leaders, most likely chief executive officers of the organizations, decide to bring together their collective expertise. The two CEOs build upon their mutual shared experiences of serving on committees, community boards, etc. together. They travel in similar circles and have developed reciprocal trust and respect. Unfortunately, a frequently overlooked aspect of this process is the fact that the managers and frontline staff who must join together to make the collaborative partnership a reality have NOT had the opportunity to develop that same level of trust. The wise leader recognizes the importance of building the trust necessary for a solid foundation between partners. Trust does not automatically filter down. Devoting considerable face time during the planning stage aids in establishing a firm foundation of trust. Dedicated time for regular interaction (weekly/monthly meetings, conference calls, etc.) helps to maintain the connection. Maintaining the flow of communication helps everyone to stay current with expectations and reduces the chance of surprises, which can quickly erode trust. Bringing together staff with their counterparts allows for those relationships to develop separately in addition to the collective partnership/relationship. It also allows issues and solutions to be addressed at the appropriate level. Medical Directors must communicate with Medical Directors; nurses communicate with nurses. When the CEOs communicate with each other in their decision-making process, they will benefit from the solidarity among the matched pairs in gathering input. Making informed decisions prevents leaders from forcing issues and promotes the trust that is so vital to success relationships.
“The glue that holds all relationships together – including the relationship between the leader and the led is trust, and trust is based on integrity.” –Brian Tracy

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