Montefiore Health System, the University Hospital for Albert Einstein College of Medicine, has been awarded two grants to improve the ability of primary care physicians in small practices to treat common behavioral health conditions, such as anxiety and depression. One in five New Yorkers experiences mental distress, which frequently affects their physical health. Most do not receive adequate care due to stigma and limited access to behavioral health services.

With $188,320 from the United Hospital Fund (UHF) and $215,670 from the New York State Health Foundation, Montefiore will support and evaluate a new guide  it has spearheaded, “Advancing Integration of Behavioral Health into Primary Care: A Continuum-Based Framework,” to help primary care providers implement  and improve access to behavioral health services in six primary care practices in New York City and five more elsewhere  in New York State.* 

“When healthcare is fragmented, people fall through the cracks,” said Henry Chung, M.D., vice president and chief medical officer of Montefiore’s Care Management Organization (CMO), associate professor, Clinical Psychiatry, Albert Einstein College of Medicine, lead author of the framework and the principal investigator of the pilot. “We will be working with small primary care practices that are critical to the overall health of so many New Yorkers. By collaborating closely with these providers, we can help amplify their behavioral health services offerings and better address their patients’ mental health needs.”

Up to 25,000 individuals will receive depression screenings and 1,000-2,000 individuals will benefit from integrated services in these practices. Using the framework, the practices aim to improve their integration activities based on their resources and geography.

Montefiore has been a leader in the integration of behavioral health in primary care. Through a Centers for Medicare and Medicaid Services innovation grant led by Dr. Chung, Montefiore patients have benefited from primary care site visits that are supported by a dedicated behavioral health collaborative care team, which may include a psychiatrist, psychologist or a social worker and care manager. Patients receive in-person introductions to behavioral health providers and participate in therapy sessions that focus on problem solving techniques. If medication is required, prescriptions are given by primary care providers with reviews and consultations from a psychiatrist. This has led to more than 2,000 patients with depression experiencing a nearly 50 percent improvement in severity of depression and associated symptoms, according to a standard patient health questionnaire. 

To advance the new pilot, Dr. Chung and his team will support the use of the framework among the participating practices, advise on primary care site-specific goals and lead monthly knowledge sharing and problem solving webinars for improving behavioral health integration. Practices will provide information about their progress, successes and barriers to advancing integration; information which is required to develop quality and sustainability strategies for small practices.  

The pilot will result in practice changing recommendations and an updated guide that will inform clinicians, policymakers, and payers on how to best advance behavioral healthcare.

Advancing Integration of Behavioral Health into Primary Care: A Continuum-Based Framework” is the product of work conducted with grant support from UHF. Published by UHF, it was written by Henry Chung, M.D., Nina Rostanski, MPH, Associate Director/Business Analyst at OneCity Health; Hope Glassberg, MPA, HRHCare Community Health, strategic initiatives and policy; and Harold Alan Pincus, M.D., Columbia University and NewYork-Presbyterian Hospital, Department of Psychiatry. The publication is available on the UHF website at https://www.uhfnyc.org/publications/881131.

 *Participating Practices Include:

•         Centro Medico de las Americas, Jackson Heights, Queens, NY

•         Champlain Family Health of Hudson Headwaters Health Network (HHHN), Champlain, NY

•         Delmont Healthcare, Far Rockaway, Queens, NY

•         Dr. Scafuri + Associates, Arden Heights, Staten Island, NY

•         Hudson River Healthcare at Hudson, Hudson, NY

•         Keuka Family Practice of Accountable Health Partners (AHP), Bath, NY

•         Koinonia Primary Care, Albany, NY

•         Metro Community Health Center, West Farms, Bronx, NY

•         Lourdes Primary Care, Owego, NY

•         Tremont Health Center of Community Healthcare Network (CHN), Tremont, Bronx, NY

•         South Shore Physicians, Bay Terrace, Staten Island, NY