Applying the Integrated Care Approach: Core-Module 3

Module 3 - Lecture Slides

Pdf Summary

Assessment as part of a collaborative care team involves considering best practices for assessment in any type of practice. This includes focusing on more patient-centered assessment, using valid behavioral health measures to support making a diagnosis, and considering a broader definition of the team. In a primary care setting, behavioral health patients may present with symptoms such as distress, substance use disorder, social anxiety disorder, and major depressive disorder. Common outpatient psychiatry presentations include mood disorders, anxiety disorders, substance use disorders, psychotic disorders, and cognitive disorders. Common primary care presentations include depression, anxiety, unexplained physical symptoms, somatic presentations, acute and chronic distress, adjustment disorders, and pain. Psychiatric consultations play a key role in clarifying diagnoses, addressing treatment-resistant disorders, and making recommendations for managing difficult patients. A different kind of assessment in collaborative care involves shaping care over time, with one session equivalent to one assessment. Valid behavioral health measures can be used as vital signs to identify problems, support diagnosis, and measure treatment response. Screening tools such as the PHQ-2 and PHQ-9 can be used for depression assessment. The assessment process should also consider the team's understanding of patients over time and utilize validated measures to improve diagnoses. Psychiatric consultants may provide direct consultation for certain patients, while indirect assessment by the care team can also be effective. Collaborative care involves gathering and exchanging information, generating a treatment plan, and providing interventions based on a diagnosis established by the team. The team should be comfortable with tolerating uncertainty and utilize complete and sufficient information to make recommendations. It is important to consider the team's must-have pieces of information for confidently making a diagnosis, and to integrate the use of valid screening instruments and patient-rated outcome measures into practice.

Keywords

collaborative care

patient-centered assessment

behavioral health measures

primary care behavioral health

psychiatric consultation

diagnosis clarification

screening tools PHQ-2 PHQ-9

treatment-resistant disorders

patient-rated outcome measures

integrated care team