Behavioral Health Integration Approaches

Southcentral Foundation’s Nuka System of Care emphasizes whole-person wellness. At SCF, mental, emotional, and spiritual wellness are considered just as important as physical wellness, and the Nuka System is designed to provide services to address all of a customer-owner’s health needs. One of the major ways SCF works to support whole-person wellness in customer-owners is through integrated behavioral health.

Behavioral Health Consultants (BHCs) are behavioral providers who are fully integrated into SCF’s primary care clinics. BHCs are available for same-day consultation with customer-owners; customer-owners can see a BHC by calling in ahead of time or by walking into the clinic and making a request. Primary care providers can also request that a BHC see a customer-owner they are having an appointment with, either with the provider or separately. BHCs also work with integrated care teams as needed for customer-owner cases.

SCF makes use of both targeted and non-targeted approaches to integrated behavioral services:

Targeted approaches to behavioral clinical work are routine operational ways of involving BHCs in care as part of the regular clinic flow. Examples of this are annual screenings for mood, substance use, or well child checks. This can also include using BHCs for chronic disease management such as persistent pain or diabetes.
Non-targeted approaches to behavioral clinical work allow provider discretion to bring a BHC in for consultation when they think it is clinically necessary and relevant. An example of this could be a customer-owner experiencing chest pain; after the medical provider rules out cardiac issues, they could bring in a BHC to explore the possibility that the pain is being caused by stress or anxiety. Or during a visit for a customer-owner experiencing fatigue, the provider could bring in a BHC to explore mood and/or sleep patterns.

Both types of approaches have their use, however a system that is just beginning to integrate will probably want to rely more on targeted approaches. This gets people thinking about behavioral needs and also serves to destigmatize them. Non-targeted approaches can often rely on training other providers so they have a better understanding of how BHCs can help in cases where they might not otherwise have thought to involve them.

For more information on targeted and non-targeted approaches to integrated behavioral services, or behavioral health integration in general, feel free to contact the SCF Learning Institute.