Behavioral Health Integration Approaches Serving Alaska Native and American Indian People

By the Southcentral Foundation

​Southcentral Foundation's (SCF) Nuka System of Care is an innovative health care model that prioritizes whole-person wellness. This approach recognizes that mental, emotional, and spiritual wellness are just as important as physical wellness and provides services to address all of a customer-owner's health needs.

One of the major ways in which SCF supports whole-person wellness is through integrated behavioral health. The organization has behavioral health consultants (BHCs) who are fully integrated into SCF's primary care clinics. This means BHCs are available for same-day consultation with customer-owners. Customer-owners can see a BHC by calling ahead or 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 for integrated behavioral services. Targeted approaches are routine operational ways of involving BHCs in care as part of the regular clinic flow. Examples of this include 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, where the medical provider rules out cardiac issues and brings 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.
 
SCF's integrated behavioral health services provide support for individuals with a range of concerns. BHCs can support customer-owners with issues such as depression, anxiety, relationship problems, stress, and trauma. They can also assist with substance use disorders, chronic pain management, and other behavioral health concerns. BHCs work with customer-owners to develop personalized care plans that take into account their unique needs and circumstances.
 
One important aspect of SCF's integrated behavioral health services is that they are designed to reduce stigma around behavioral health concerns. By bringing BHCs into primary care clinics and making them a regular part of the care team, SCF aims to make it easier for people to seek help for behavioral health concerns. SCF also offers a range of educational resources and training opportunities to help health care providers and customer-owners better understand behavioral health concerns and how to address them.
 
Overall, SCF's Nuka System of Care is an innovative health care model that prioritizes whole-person wellness and provides integrated behavioral health services to support individuals with a range of concerns. By making BHCs a regular part of the care team and using both targeted and non-targeted approaches to behavioral health services, SCF is working to reduce stigma around behavioral health concerns and provide personalized care to individuals in need. If you are interested in learning more about SCF's integrated behavioral health services, you can contact the SCF Learning Institute for more information.
 

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