Growing Awareness of Mental Health Services

To improve mental health services in the Carolinas, The Duke Endowment awarded nearly $6 million to help integrate mental health with primary care in North Carolina and use telepsychiatry for crisis mental health care in South Carolina.

Insights

Several strategies drive our approach to mental health grants. We invite others to use these findings as a starting point for their own efforts.

ICARE Partnership (North Carolina)

1. Strong communication among community health stakeholders fosters the collaboration needed to coordinate mental health and primary care services.
2. A dynamic web presence has been critical to successful educational and public relations efforts.
3. Taking a long view to cost reductions through integration is key. While patient costs may be elevated initially due to therapy and medications, the higher-ticket costs of chronic disease and emergency room visits are expected to drop.
4. Successful collaboration among health care providers should include a variety of stakeholders. Public agencies and larger partnerships are more likely to get involved, while smaller practices may not have staff available for meetings or be willing to take on unbillable projects.
5. For busy primary care practices, protocols must be simple enough to manage.
6. Sustainability depends on looking for creative ways to access state dollars, case management services and private funding.

Telepsychiatry (South Carolina)

1. A critical starting point for developing a telepsychiatry network is creating a web-based guide to resources in each community. This helped hospitals and telemedicine providers form a common pool of knowledge, rather than each participating hospital functioning independently with little awareness of other efforts.
2. Having mobile, wireless telemedicine carts helped increase patient comfort and convenience by making it possible for them to be diagnosed in the privacy of their own hospital room.
3. The telemedicine carts also can be used to train hospital staff in a cost-effective and efficient way.
4. Developing a common credentialing system for psychiatric services providers helps increase efficiencies.
5. Partnering with hospital associations and public health and human services departments to develop billable service codes has been an important step for the project's long-term sustainability.

Impact

ICARE Partnership (North Carolina)

Efforts to integrate mental health and primary care in North Carolina through the ICARE Partnership has resulted in:

• Increased collaboration and communication
• Improved access to services
• Increased awareness that has helped primary care providers learn about mental health resources and referral options in their communities
• Increased provider and patient satisfaction
• Increased uses of non-emergency behavioral health services
• Reduced costly emergency department visits

Telepsychiatry (South Carolina)

The telepsychiatry program is expected to reduce time mental health patients spend in emergency departments by 50 percent, saving hospitals and patients money. By accurately diagnosing and treating patients earlier, the program is expected to help reduce or eliminate many future visits and long-term problems.

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