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Learning to Fly: a journey into teaching and mentoring in IBH

Monday, June 15, 2020

Osprey hovering over nest with hatchlings

The journey

In the midst of a world-wide pandemic, behavioral health needs have grown to epidemic proportions among many who have no history of mental illness, as well as those who have long experienced mental illness. In an analogy that many have used, it often feels like learning to fly while already in the air. From this perspective, I feel compelled, as a health psychologist trained in integrated care, to consider how mental health clinicians may find innovative ways to use their skills in assisting systems of care that need our guidance most.

Providing behavioral health services within primary care has long been my passion. My training in Health Psychology took place before there were widespread integrated care opportunities. Experiences ranging from being one of the first cohorts at Cherokee Health in Tennessee for my internship when it was not yet a national model for providing integrated care to completing my post-doctorate fellowship at UMass Chan Medical School when it was well established as being a center for the advancement of primary care psychology helped to define me. So, it was a rude awakening to learn there were hardly any clinical job opportunities available when I was done getting educated and trained within Integrated Care.

Sometimes there were grant-funded pilots, but mostly there were many cold calls and emails and connections that I tried to make among primary care organizations in order to persuade them that creating a role for behavioral health professionals like me in integrated care would be the next big thing in healthcare. I started helping to build a foundation of integrated care at any primary care organization that had the vision to see what the future could hold. Success at one would mean that word would spread and then another practice would become interested and I could offer them the knowledge and skills they would need for the transformation to IPC.

I began to see that for me to be able to do the clinical work that I felt so strongly about providing at the frontlines of primary care, I would need to be a part of the leadership movement

Quickly, I began to see that for me to be able to do the clinical work that I felt so strongly about providing at the frontlines of primary care, I would need to be a part of the leadership movement working to build new integrated programs into existence. Dr. Sandy Blount, who formerly ran the Center for Integrated Primary Care at the University of Massachusetts, and Dr. Parinda Khatri, Chief Clinical Officer at Cherokee Health Systems, are critical influencers in this movement who have impacted me most.

The tipping point

I began to stop looking for organizations that were at the tipping point as they began to look for me to assist them in building the bridge to integrated care. Soon I was receiving more requests than I could manage with even 100% of my expertise and time. Organizations would often state, “If only there could be more of you…” and it was then when I realized that 15 years of building integrated care from the ground up at over 30 primary care organizations was not sustainable unless I could train others to do the same.

Initially, I developed an in-person course that distilled all of my experiences as an integrated care practice facilitator into eight hours of training over six months, with monthly phone calls and shadowing opportunities. After a number of these in-person offerings, I realized that the pool of trainees was too limited to effect widespread change. Even though I was spending so much effort trying to be and train practice facilitators, I was based in Rhode Island, the smallest state so in-person training was only reaching a limited audience.

I knew that more and more behavioral health professionals were already working in primary care settings and were now seeking to deepen their learning or wanted to share what they had learned working as members of integrated teams.  There were more and more individuals who shared my passion. 

I realized that I could further distill the initial training I had designed into a 3 ½ month program that was online and self-directed while still offering phone calls and shadowing opportunities. This advanced integrated primary care online training program launched in early 2020 with offerings in the Spring and Fall (the Fall session will be starting in September 2020). The program is geared towards any clinician who has been working in an integrated care setting providing behavioral health within primary care and who is thinking about how to help either their own organization make the jump to the next steps or help other organizations make the jump. If you are interested in learning more, please visit: LINK