Featured Articles: PCMH

Crisis Intervention Integration with Primary Care and Behavioral Health

Friday, May 12, 2017   (0 Comments)
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Susie Kroll, Behavioral Health Clinic Manager, Meridian Center for Health


Susie will be presenting on this topic at the Spring Primary Care Conference in Spokane


“No one will help me.”  “I give up.”  “I think about suicide and can’t stop it, but I don’t want to kill myself.”  “So what, I use meth, whatever, it helps with my depression.”  These are common phrases often heard at the Meridian Center for Health.  The difference is primary care medical, dental, Public Health, and behavioral health are all in-house.  Often times we have patients and clients presenting in crisis or being referred to us via the fire department or law enforcement.  In other instances, we have patients presenting for medical care that endorse behavioral health issues needing attention and assessment or vice versa.  Historically this assessment has been the defacto responsibility of local emergency departments and medical staff. 


The Meridian Center for Health is a pilot program designed to integrate the expertise of each field of service while insuring that the connection time to experts and the coordination of care is almost immediate.  We opened December 16, 2015 and have enjoyed serving the North Seattle area, meeting an incredibly underserved population.  Meridian Center for Health allows the service providers to effortlessly serve and treat the patient without having to work outside their scope of expertise and training.  It also allows for the coordination of care and consistent service to the patient.  For example, if Dr. Smith diagnoses a patient with Type II Diabetes, the patient may feel symptoms of depression and/or anxiety that manifest due to the diagnosis.  These symptoms may impact the patient’s ability to comply with doctor’s orders for stabilization with medical care.  The patient is referred to behavioral health for assessment and integration into care for the behavioral health symptoms.  The patient is also referred to Public Health for coordination with a nutritionist and food preparation classes in our teaching kitchen.  These systems work together to empower the patient to take care of their own nutritional needs, manage symptoms of stress, and these elements better allow the patient to comply with doctor’s orders for the maintenance the disease.  All of these systems and services work in tandem via patient care and cross-service consult.        


Further, at the Meridian Center for Health, there is an integrated Suboxone Recovery Program in which patients are provided Suboxone by a qualified medical professional and provided assessment and placement via ASAM approved substance abuse recovery and treatment via qualified Chemical Dependency and Licensed Mental Health Professional.  These professionals meet and consult on cases to provide continuing care for the patients they serve. These partnerships have become an integral part of the level of service provided to all our patients.  While they are relatively new, they have become common practice and expected by our patients and providers.  We could not do our work with expertise if we were not able to coordinate care so effortlessly. 


Meridian Center for Health takes this coordinated care a few steps further.  We have created and fostered partnerships with outside service providers.  These providers meet frequently to update referral processes, coordinate crisis assessments, and decrease the revolving door of services typically actuated by crisis and 911 calls.  These include but are not limited to local emergency departments, inpatient units, schools, fire departments, jails, and law enforcement.  Meridian Center for Health is able to provide services to local fire departments and law enforcement as part of a low acuity drop off program.  Meaning, when law enforcement or the fire department come into contact with people that do not meet criteria for transport to emergency departments for involuntary holds but clearly could benefit from care and not being left on scene, they are transported to our site.  We are able to triage non-emergent medical needs, provide crisis intervention and assessment, and integration into our levels of provided services. 


Meridian Center for Health has proven, in a little over a year and a half that individual patient care, coordination of care, provider consult, and partnerships with outside agencies have led to improved patient outcomes and made the new idea of integration feel as though it has been around for thousands of years.  Patient care that is new and unexpected and all together easily settled into as a necessary and life-improving facet to health and wellness.


NWRPCA welcomes and regularly publishes white papers and articles submitted by members, partners and associates with subject matter expertise. The appearance of any guest publication in our Health Center News database represents the views of the author and does not constitute endorsement by NWRPCA of the stated opinions or perspectives, nor does it suggest endorsement of the contributor's products or services.


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