Partners in Integrated Care (PIC)

What We Did:

MHQP led the Massachusetts implementation of a national initiative focused on incorporating evidence-based screening tools and early intervention services for depression and unhealthy alcohol and substance use into routine primary care for adults in the primary care office setting.

The goal of the Partners in Integrated Care (PIC) model of care was to increase the identification and treatment of behavioral health problems by incorporating two evidence-based approaches into routine primary care: Screening, Brief Intervention, and Referral to Treatment (SBIRT) for unhealthy alcohol and substance use, and Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) for depression.

MHQP recruited four primary care offices in Massachusetts and coordinated training and implementation support for these participating practices on:

  • Motivational Interviewing
  • Screening
  • Behavioral Activation and Developing Self-Care Activity and Maintenance Plans
  • Brief Interventions for alcohol and other drug use
  • Key steps during the initial and follow-up contacts for depression
  • Communicating with the PCP and consulting psychiatrist
  • Coordinating referrals and connecting patients to community resources

MHQP helped with electronic documentation and also provided each site with a coach whom they met with on an ongoing basis to discuss cases and issues that arose.

Who Was Involved:

This initiative was funded by the Agency for Healthcare Research in Quality (AHRQ) and led by the Pittsburgh Regional Health Initiative (PRHI). MHQP worked with PRHI and other regional health improvement collaboratives in Minnesota and Wisconsin, who have implemented the PIC model in primary care in their regions, to disseminate and implement the PIC Model in Massachusetts. MHQP recruited four practices to participate in the Massachusetts program: Cambridge Health Alliance’s Revere Family Health Center in Revere and Everett, the MGH Chelsea Health Center, and the Internal Medicine and Adult Primary Care Group at Tufts Medical Center.

Why This Work Matters:

Behavioral health problems, such as depression and unhealthy substance use, are prevalent in the United States. These health issues exact a very high toll on society and yet, behavioral health problems are often undiagnosed and affordable treatment is not widely available, creating a serious public health challenge. Primary care practices can help address this problem by increasing early identification and treatment services for patients with behavioral health issues. This makes sense because:

  • There is less stigma associated with going to see a primary care provider;
  • People are more likely to contact their primary care provider than any other health care professional when they start to experience new symptoms; and
  • Behavioral health problems often cause, aggravate or accompany other chronic health problems that require coordination from a primary care provider.

MHQP continues to measure patient experience with behavioral health screenings in Massachusetts primary care practices through our annual Statewide Patient Experience Survey. We have found that practices in which behavioral health is integrated with primary care have increased frequency of patients being asked about their health goals.

In 2017, MHQP fielded a first-of-its-kind statewide study of patient engagement activities in primary care practices in Massachusetts, with support from CRICO, which identified innovative strategies for integrating behavioral health services into primary care.

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