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| IMPLEMENTATION STORIES
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RESPECT-Depression in Utah
Intermountain Healthcare System was one of the health care organizations that participated in the initial Re-Engineering Systems in Primary Care Treatment of Depression (RESPECT-Depression) Trial. With support from The MacArthur Initiative on Depression and Primary Care, our organization has been able to integrate the Three Component Model into routine care.
Over the last 3 years, Mental Health Integration has been adopted as part of the routine process of care in over 40 primary care practices throughout the Intermountain system and 20 more are being added now. It is clear that the beginning of this entire project goes back to our participation in the MacArthur RESPECT-Depression trial.
At Intermountain we had been moving forward and planning to develop a mental health integration process. However the experience, tools, collaboration, technical support and clinical consultation we received as participants in the RESPECT-Depression trial accelerated our efforts and dramatically improved the quality of care for patients with mental health conditions.
The “prepared practice” model provided a basis for changing culture throughout our system. This model easily expanded for complete implementation of Mental Health Integration at our sites. Clinical tools such as the PHQ-9 and the suicide risk assessment protocols (see Tool Kit) were also new to us and proved very valuable. Intermountain took the idea of a “prepared practice” and expanded it to a full Mental Health Integration team. The team includes primary care clinicians and their staff at participating practices working with care managers, psychiatrists, advanced practice nurses, psychologists, and social workers.
We have further developed and refined the history taking and evaluation tools that help the primary care clinicians increase efficiency and accuracy in diagnosing and following patients with depression and other mental health conditions. As a result, there is now a culture of Mental Health Integration that permeates Intermountain primary care with similar potential for secondary care, both clinically and operationally.
Results have shown dramatic improvements in primary care clinician satisfaction, staff satisfaction, and patient satisfaction. The expense has been neutral or positive for both our health plan and our primary care facilities that employ Mental Heath Integration. Support from The MacArthur Initiative on Depression and Primary Care and from 3CM consultants has been a critical element in improving care for patients with mental health conditions throughout our system.
Brenda Reiss-Brennan MS, APRN, CS
Mental Health Integration Leader
Intermountain Healthcare
Wayne Cannon, MD
Primary Care Clinical Program Leader
Intermountain Healthcare
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