Health First Behavioral Wellness Advice: Bring Your Worries to Your Doctor’s Door

By  //  January 31, 2024

Let’s take stock of who we are, and how we hope to grow and develop

ELISABETH XAVIER is a Licensed Mental Health Counselor who has served as a Behavioral Care Manager since the beginning of Health First’s Onsite Collaborative Care program. “In Brevard County, you can be on a waitlist for three months to find a prescribing Provider,” Elisabeth Xavier, Licensed Mental Health Counselor at Health First, told me. “With us, it’s one week, two tops.” (Health First image)

At Health First, Onsite Collaborative Care is making your regular checkup the right time to address mental health needs.

I love new year’s resolutions, and I don’t care what surveys say about how many of them make it to February (not many). It’s a healthy exercise. Let’s take stock of who we are, and how we hope to grow and develop.

I was encouraged when I read a Forbes Health story that listed “improved mental health” as a top 5 resolution for 2024 – picked by more people than “lose weight” and “improve diet.” Wow! I feel so – validated.

Health First patients have a real advantage on this front. They can begin addressing their mental health at their next scheduled doctor’s appointment.

Onsite Collaborative Care

Two years ago Health First began its Collaborative Care Management program – psychotherapeutic counseling and prescription management brought into your primary care office. We pair patients in mental health distress, because of a diagnosis or not, with a specialist.

Last year, the program made more than 1,400 referrals and welcomed 450 new admissions. Not every patient asking for a mental health intervention needs to see a psychiatrist.

“In Brevard County, you can be on a waitlist for three months to find a prescribing Provider,” Elisabeth Xavier, Licensed Mental Health Counselor at Health First, told me. “With us, it’s one week, two tops.”

BCMs

Provider-identified patients get a Behavioral Care Manager (BCMs). BCMs use motivational interviewing techniques, identify situational stressors and introduce solution-focused counseling, and discuss drug therapies. They write a personalized care plan focused on a patient’s mental health needs.

At Emory Medical Center in Atlanta, wide-ranging research found that 1 in 20 appointments made with a Primary Care Provider (PCP) were primarily to address mental health concerns.

Doctors’ offices are not the wrong place to bring up mental health – quite the opposite. Patients feel safe sharing there. But that does make their Provider a gatekeeper.

“These are patients experiencing mild to moderate anxiety and depression, insomnia, even bipolar behaviors, and the goal is providing solution-focused therapy, positive coping skills, and medication management,” says Xavier.

Behavioral Care Managers use a short survey to gauge and measure improvement. It’s called the nine-item Patient Health Questionnaire. It’s quick, less than three minutes, typically.

The PHQ-9

Behavioral Care Managers use a short survey to gauge and measure improvement. It’s called the nine-item Patient Health Questionnaire. It’s quick, less than three minutes, typically.

The questions touch on loss of interest or pleasure in everyday activities, trouble sleeping (or sleeping too much), changes in appetite or ability to focus, and thoughts of harming yourself. A tenth question asks how difficult work and home life have become since the onset of these developments.

It’s a diagnostically significant tool, and it helps us mark improvement (or not).

Psychiatrist

One of the most valuable things Onsite Collaborative Care offers is access to consulting psychiatrist Jordan Brown, MD. Dr. Brown consults with both the BCM and the PCP.

“We’re truly all hands on deck for you,” Xavier said.

Demand for mental health services is higher than ever, but a workforce shortage in the profession means simply getting a timely appointment with a psychiatrist or prescribing mental health provider is a tall order. And many of these don’t accept most insurances.

With Onsite Collaborative Care, your BCM is your point of contact, and your PCP writes your scripts, should you be prescribed medicine.

Whole-Patient Wellness

The following diagnoses carry an increased risk for depression – heart failure, irritable bowel syndrome (IBS), chronic obstructive pulmonary disorder (COPD), and diabetes. And there are others. Similarly, a mental health diagnosis can manifest physical symptoms. Physical well-being and mental wellness are strongly correlated.

“At their family doctor, patients open up the floodgates about daily life stressors,” Xavier told me, “and where we come in, we help that provider focus on physical health while we take the mental health off their plates. The patient as a whole is served this way.”

Onsite Collaborative Care takes place at these Health First Family and Internal Medicine locations:

■ 1810 Eldron Blvd. SE, Palm Bay
■ 730 Malabar Road, Palm Bay
■ 1223 Gateway Drive, Melbourne
■ 7125 Murrell Road, Viera
A referral from a Provider is required.

To learn more, or to schedule a confidential consultation with one of our clinicians, call 321.434.7604 or visit HF.org/behavioralwellness to learn more.

ABOUT THE AUTHOR: DeAnn Collins, above, is a Licensed Clinical Social Worker and Program Manager at Health First’s Behavioral Wellness where she oversees intensive outpatient programs and assesses new patients. She has specialized in senior mental health needs and treatments. She is committed to daily mindfulness practice and is a devoted animal lover who may be spotted “in the wild” at Disney theme parks with her daughter or friends.

ABOUT THE AUTHOR: DeAnn Collins is a Licensed Clinical Social Worker and Program Manager at Health First’s Behavioral Wellness where she oversees intensive outpatient programs and assesses new patients. She has specialized in senior mental health needs and treatments. She is committed to daily mindfulness practice and is a devoted animal lover who may be spotted “in the wild” at Disney theme parks with her daughter or friends.

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