In previous years, the integration of behavioral health and primary care services has improved mental health care. One model, in particular, the collaborative care model, is more efficient than other integrative care models.
In the collaborative care model, a combination of specialists, including a primary care provider (PCP), behavioral health care managers, psychiatrists, and other mental health care management staff such as a nurse, clinical social worker, and psychologist, work together to provide a care plan for patients.
A collaborative care model is a team-based approach to healthcare that increases patient resources and self-management support systems.
But what is the value of the collaborative care model in the digital mental health space? Can the collaborative care model increase referrals to digital apps and promote patient engagement?
In this article, we discuss the effectiveness of the collaborative care model and its potential to increase referrals to digital mental health apps.
The collaborative care model is more effective than usual care
The evidence tells all. The Cochrane Collaboration, US Community Preventive Services Task Force, and leading mental health researchers, analyzed and reviewed the literature. Their findings suggest that the collaborative care model is more effective than usual care for improving mental health outcomes for periods of up to two years.
In addition, more recent findings from a report by the American Psychiatric Association (APA) show that among all integration models the collaborative care model has the most evidence for effectiveness and efficiency in controlling costs, improving access, improving clinical outcomes, and increasing patient satisfaction.
The collaborative care model is also recommended as a best practice by the Surgeon General’s Report on Mental Health, the President’s New Freedom Commission on Mental Health, and other national organizations such as the National Business Group on Health.
According to the APA, the collaborative care model has five essential elements:
Patient-centered team care - The team uses shared care plans that incorporate patient goals, e.g., a familiar location where the patient receives physical and mental health care.
Population-based care - One problem patients experience, especially those with limited access to effective mental health care, is a lack of follow-through. In a collaborative care model, the team tracks patients in a registry to ensure no one falls through the cracks.
Measurement-based treatment to target - The team measures all patient goals and clinical outcomes using evidence-based tools, for example, the PHQ-9 scale for depression.
Evidence-based care - The team treats patients using the most updated research.
Accountable care - Providers get rewarded for their clinical outcomes (pay-for-performance) and not just for treatments (fee-for-service).
Integrating a digital mental health platform into a collaborative care model can significantly improve the outcomes of patients experiencing mental health issues. Patients can follow up on their care by utilizing digital platforms that provide additional services for mental health.
Barriers to referring patients to mental health specialists
Primary care providers continue to face barriers when referring patients to mental health specialists.
We’ve highlighted three barriers below.
1. Payer models discourage integrated primary care - Value-based care is collaborative in nature; however, many payer models do not support it yet. In recent years, Medicaid redesign efforts have shifted toward moving providers toward value-based reimbursements that support collaborative care models. However, the transition is still challenging.
2. Lack of integration of digital mental health services in clinicians’ workflow - It is challenging to refer patients easily when digital mental health systems are not integrated into clinicians’ workflows.
3. Lack of awareness about digital mental health platforms - According to a case study by Kaiser Permanente, many clinicians and patients are not yet familiar with mental health and wellness digital platforms. Lack of familiarity results in fewer referrals to digital offerings.
Can the collaborative care model increase referrals to digital mental health platforms?
The Kaiser Permanente case study mentioned above discovered that the language clinicians use can strongly influence patient choices, partly because the patient-provider relationship depends on trust. As a result, clinician referrals to digital apps can increase the uptake and engagement of digital mental health tools.
A collaborative care model can increase digital mental health referrals by:
1. Building on existing relationships - Once people find a good healthcare practitioner, they tend to use their services for years. The physician-patient relationship thrives on trust. One key insight from the Kaiser Permanente study is that trust is a prerequisite for engaging patients in mental health and wellness care. People respect what experts say. The collaborative care model can use this to its advantage by increasing digital mental health referrals.
2. Helping to decrease stigma around mental health - People experiencing mental health conditions may not seek help because they are afraid of being treated differently. They may prefer using online resources as opposed to seeking traditional mental health services. The collaborative care model is a way to extend mental health care from the bedside to the home, which can increase patient engagement.
3. Leveraging millions of people who use mobile health and wellness apps - According to research, smartphone penetration in the US is 81%. But despite the widespread use of digital apps that help with mental health, these apps are not yet widely integrated into medical settings. Apps are a direct extension of care rather than options patients seek out on their own. Approximately 70% of people living with depression and anxiety are interested in using digital mental health tools, but according to NCBI, only 10% have sought them out. If the collaborative care model directs more people toward these digital apps, there would be an increase in usage and engagement.
Next steps: training clinicians in a collaborative care model
The collaborative care model can significantly increase the uptake of and engagement of digital mental health platforms and apps. It can also help to reduce the stigma surrounding mental health by incorporating digital mental health tools.
The next steps should involve training more clinicians to integrate these digital mental health tools into their workflow. The APA offers free training in the collaborative care model for psychiatrists, primary care providers, and behavioral health care managers.
In addition, you should choose a trusted partner for your digital mental health platform. With nearly two decades of clinical research and validation on real users, you can trust the integrity of SilverCloud® by Amwell®’s data.
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