VISION: The First Key Component of a Successful Behavioral Health and Primary Care Marriage

Every relationship follows a similar pattern. The early phase begins with the selection of a partner. The same holds true for the integrated behavioral health and primary care partnership. It may begin with running into each other at a meeting. Or perhaps while reading the lastest report on the emerging trend of healthcare integration, Accountable Care Organizations, health homes, etc…

The Vision begins to form                          

The behavioral health and primary care clinics enter into the dating relationship when the leaders of each, who have mutual admiration for each other, begin to recognize the potential of doing business together. One leader calls the other, suggesting they get together for lunch. It’s only lunch, he rationalizes to himself, it doesn’t mean anything…there’s no harm just in talking….

One thing leads to another during the wooing and courting phase; soon the idea transitions and the outline of a plan begins to emerge. The two leaders have entered the early stages of the partnership. The Vision is being created, becoming a driving force for each.

The two organizations soon find themselves having serious discussions about forming a partnership. How did THIS happen?? The proposal is followed with a flurry of planning. There are so many details! Attorneys are kept busy creating a business plan and reviewing financial and regulatory documents, planning for the wedding of two organizations. Decisions must be made of how the assets are to be shared. Finances are sorted, MOUs are signed, and the partnership is official.

The marriage of behavioral health and primary care creates a unique entity that is far greater together than either had, or could have been, alone.

The early stage of the partnership is filled with excitement as the Vision takes shape and becomes reality. The shared vision is driven by the passion to become what neither can achieve alone. The specialty behavioral health provider and the primary care provider have integrated, raising the bar of healthcare for people with behavioral health disorders.

This marriage of healthcare providers is based on a Vision shared by two of eliminating the health disparities of people who suffer from serious mental illness and substance use disorders.

Next time we will explore the second key component of a successful behavioral health and primary care marriage:  Communication.

The Behavioral Health and Primary Care Marriage

We have ascertained in previous posts the value of the integrated behavioral health and primary care partnership. With shrinking healthcare funding and the unmet healthcare needs of people who have serious behavioral health disorders, there are numerous benefits of collaborative care. The blending of resources, expertise, and passion combine to create a synergy that is not possible with one organization alone.

Healthcare Integration Timeline

  • In 430 BC Hippocrates declared:
    “The Body must be treated as a whole and not just a series of parts” 
  • Literature by Dr. Benjamin Maltzberg dating back more than 75 years on studies at the New York State Hospital in Utica has reported “excess mortality due to medical causes in persons with mental disorders”
  • 1999 Surgeon General’s Report on Mental Health
    ◊ First major emphasis on integrated care
    ◊ Dr. David Satcher declared:
       “There is no Health without Mental Health”
  • 2006 NASMHPD Report, Morbidity and Mortality in People with Serious Mental Illness:
    ◊ People with serious mental illness are dying 25 years earlier than the general population
    ◊ 60% of premature deaths are due to modifiable and preventable medical conditions

The Primary and Behavioral Healthcare Partnership

  • Allow for individual choice in determining the healthcare home
  • Ideal for treatment of the whole person
  • Address the health disparities of people who live with serious behavioral health conditions
  • Bi-directional integration allows for individual choice in determining the healthcare home
  • More efficient and effective use of healthcare dollars
  • CNN Report: Companies merge for a variety of reasons
    ◊ Expansion of market share
    ◊ Acquisition of new lines of distribution or technology
    ◊ Reduction of operating costs
    ◊ Corporate mergers fail (up to 80%!) for some of the same reasons that marriages do –
       A clash of personalities and priorities

Four Key Components of a Successful Behavioral Health and Primary Care Marriage

Like all marriages, the behavioral health and primary care marriage requires nurturing. There are four key components that occur at integral stages within the relationship that must be addressed for successful outcomes, aka living happily ever after.

  1. VISION
    > DATING: Partner Selection
        • Mutual attraction
        • Determining potential
        • Wooing and courting
        • Proposal

    > The WEDDING: Formalizing the Partnership
    • Merging of goals
    • Co-location
    • Finances

  2. COMMUNICATION
    > Early Phase: The HONEYMOON
    • Identify a common language
        • Sharing decision-making
        • Synergy
    > Problems within the Partnership (AKA The HONEYMOON is OVER!)
        • Addressing internal conflicts
        • The use of candor
        • Temper expectations
  3. COMPROMISE: Making it Work
    >MARITAL COUNSELING
       • Developing shared solutions
       • Delegate trust
       • Create empowerment
       • Determine expectations
  4. OUTCOMES
    >The MATURE PARTNERSHIP: Growing Old Together
       • Enhanced outcomes through blending of resources
       • The whole is greater than the sum of its parts
       • Accountability

In the next post we will explore the early phase in the relationship, the  first key component, Vision.