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To establish the reliability and validity of the Family CAGE (an acronym indicating Cut down on drinking; Annoyed by complaints about drinking; Guilty about drinking; had an Eye-opener first thing in the morning), a four-item instrument intended to assess family alcohol-related problems.
Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling...
The common narrative is coronavirus disease 2019 happened, payment and policy barriers were quickly lowered, and voila, telemedicine, a technology for which adoption had been slow over the past decade, is, within a matter of months, in widespread and successful use. Fait accompli. On to this narrative has been grafted the hopes that telemedicine will solve other persistent problems, particularly in primary care.
This change guide is designed to assist primary care clinicians and leaders to integrate care for patients with unhealthy alcohol and/or other drug use into routine medical care. As behavioral health care is increasingly integrated into medical settings, especially primary care, the focus is often on depression and anxiety. Care for alcohol and/or other drugs is often omitted or minimized, likely reflecting: stigma, lack of workforce training/education, and the traditional separation of care for alcohol and other drugs from traditional health care (e.g., primary care, emergency care, and behavioral health, etc.). This guide expands on and updates the widely recognized model of Screening, Brief Intervention, and Referral to Treatment (SBIRT).
IBHA recommends that health systems, insurance plans, and others looking to measure progress toward integrating behavioral health in primary care use the 2017 PCPCH Standard 3.C.3 as the integration metric of choice. At the system level, IBHA concurs that measuring practice-level progress toward adopting excellent integrated care delivery models in the most meaningful way to affect system change.
When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid.
Comorbidity also implies that the illnesses interact, affecting the course and prognosis of both.1,2 This research report provides information on the state of the science in the comorbidity of substance use disorders with mental illness and physical health conditions.
This handout offers background information and tips for providers to keep in mind while using person-first language, as well as terms to avoid to reduce stigma and negative bias when discussing addiction. Although some language that may be considered stigmatizing is commonly used within social communities of people who struggle with substance use disorder (SUD), clinicians can show leadership in how language can destigmatize the disease of addiction.
Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long-term conditions. One goal of these efforts is the coproduction of activated, informed, engaged, and motivated patients and citizens.
This is a short reference guide to developing a structure to enhance the referral experience for providers and service recipients. It covers setting standards for partnership starting with your value proposition. It outlines the continuum of provider relationships from informal agreements through forming a business entity and finally provides initial guidance and further resources for establishing care compacts.
This document represents a collaboration between the American Psychiatric Association (APA) and the American Telemedicine Association (ATA) to create a consolidated update of the previous APA and ATA official documents and resources in telemental health to provide a...
There is a need for an organizing model that assists practices and policy-makers to prioritize the steps of integration implementation and the need for both technical assistance and funding for key program elements. In order to advance evidence-based integration of general health care in BH settings, clinics have become intensely interested in the underlying steps they can take to implement and advance specific general health practices.
Based on a targeted literature review and input from diverse stakeholders, the framework presented in this report seeks to provide BH clinics and other organizing entities, such as New York State's (NYS) Behavioral Health Care Collaboratives (BHCC) and Behavioral Health Independent Practice
Associations (IPA), with practical guidance using a continuum-based road map approach on the intentional and incremental steps to achieve and advance key subdomains of integrated care for community BH clinics.
What is less clear has been how to accomplish that at scale, given the varying types of primary care practices and, in particular, the resource limitations of small and medium-size practices and the complexity of the models that are currently the evidence-based standards for integrating medical and behavioral care. This framework seeks to fill that gap by delineating a series of steps that providers can take to move toward the integration of behavioral health services into their primary care practices.
The toolkit contains a variety of information and resources including a step by step guide about:
education about tobacco use
skills for engaging people in tobacco cessation discussions
efficient methods for assessing readiness to quit
information and research on treatments
The research presented by these three groups seeks to prioritize desired treatment outcomes as defined by diverse people with lived experience. From this information, the researchers crafted recommendations that could help policymakers, providers and researchers develop, implement, reimburse and evaluate more engaging and perhaps effective substance use services.
The goal of the ICTA program is to improve care and Medicaid beneficiary outcomes within three practice transformation core competencies:
Delivering person-centered care across the care continuum
Using population health analytics to address complex medical, behavioral health, and social needs; and
Engaging leadership to support value-based care.
This document provides more detail, including sub-elements for each core competency.
This document contains information about assessing the need for treatment; initiating MAT; monitoring patient progress and adjusting treatment plan; deciding whether and when to end MAT.
The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening tool developed by the WHO to assess alcohol consumption, drinking behaviors, and alcohol-related problems.
Screening and brief intervention provides an opportunity for clinicians to intervene early and potentially enhance medical care by increasing awareness of the likely impact of substance use on a patient’s overall health.
This document consists of common questions and concerns about Medication Assisted Treatment for Ambivalent patients. This document can be used as a starting point to have conversations with your patients. In the end, the patient will be able to make an informed decision that’s in line with their values and hopes for recovery.
Patients can use this Early Recovery Handout to determine behaviors when cravings or urges arise or behaviors have changed. The document provides strategy to mitigate any behavioral outliers while keeping the patient on track from day to day.
This article reviews research findings in the following 7 areas: location of buprenorphine induction, combining buprenorphine with a benzodiazepine, relapse during buprenorphine treatment, requirements for counseling, uses of drug testing, use of other substances during buprenorphine treatment, and duration of buprenorphine treatment.
The Medication-Assisted Treatment Of Opioid Use Disorder pocket guide to provide guidance on how to assess the need for treatment, referring to higher levels of care if necessary and the approved frequency and route of administration for treatment of Opioid Use Disorder. In addition, a tool has been provided to determine clinical opiate withdrawal.
The Substance Abuse and Mental Health Services Administration provides guidance for substance use disorder treatment services during the COVID-19 pandemic. The document specifies when a medical emergency exists, 42 C.F.R Part 2 does not apply and any disclosure of medical information is temporarily exempt for purposes of medical treatment.
The frequently asked questions document discusses how providers can provide Opioid Treatment to existing and new patients, and dispense medications via Telehealth while still meeting the 42 C.F.R. 8.11 requirements.
The frequently asked question document makes recommendations on how to care for patients during the COVID-19 pandemic in Mental Health Rehabilitation Centers and Psychiatric Health facilities. The recommendations suggest how to provide Telehealth services, and how to provide medical care for positive COVID-19 patients.
This document is a resource for behavioral health facilities to better understand how to treat patients and refer patients for medical care during the COVID-19 pandemic.
