Supporting staff and patients to move towards collaborative care; integration of behavioural health consultants

Abstract

Background: Empathetic and collaborative interactions are core skills in delivering behavioural interventions. Objectives were to develop and evaluate the role of the Behavioural Health Consultant (BHC) within an integrated primary care team, which aimed to support the team towards working collaboratively with patients, in addition to the BHC working directly with patients, with a view to improve population health. Methods: Based on the “Nuka†practice of integrated primary care in South Central Foundation in Alaska and Health Psychology expertise, the BHC role was developed as part of a pilot in a primary care. A pre-post evaluation of patients seen by the BHC was undertaken examining lifestyle, depression (PHQ-9) and wellbeing (Warwick Edinburgh Mental Wellbeing Scale). The impact of the BHC on interactions between staff and patients was measured using community-level data on lifestyle (e.g. BMI) What went wrong: Post-intervention data were only available for 2 of the 22 patients seen by the BHC over 3 months. Measures of change in patients the team were seeing was not possible since the pilot finished early. Possible solutions: Post-intervention questionnaires could be delivered using several options (e.g. post, email, phone app), and an incentive used to support completion. Conclusions: Situating the BHC as part of the integrated primary care team reduced barriers to access for behavioural interventions, and involved team development in collaborative care. The impact of that intervention on individual or community/population health was not able to be explored, therefore further research and evaluation is required to fully test this model.