Extending the Clinical Impact of Behavioral Health Prescribing Clinicians Using the Collaborative Care Model

For years, the prevalence of behavioral health conditions has been increasing in the United States, with the COVID-19 pandemic exacerbating this troubling trend. The demand for behavioral health treatment currently far outpaces the supply due to an understaffed and unevenly distributed behavioral health treatment delivery system (especially for prescribing clinicians), resulting in high utilization of acute services and poor outcomes.

The results of a novel study by experts from the Meadows Mental Health Policy Institute, published in the Journal of General Internal Medicine, suggest that Collaborative Care programs have the potential to mitigate behavioral health access challenges and workforce shortages, all while providing evidence-based and financially sustainable care to patients at scale.

To conduct this study, researchers compared the expected counts of new patients that could be reached by a single mental health prescribing clinician working the same number of hours per week over the course of one year in Collaborative Care versus traditional practice.

Findings from this evaluation demonstrate that Collaborative Care is at least as efficient as traditional treatment, with the added potential of substantially extending clinical impact. Results showed that Collaborative Care can extend the treatment reach of prescribing clinicians to as many as eight times the number of patients that they could see in traditional one-on-one care.

“Findings from this novel analysis demonstrate how the team-based structure of Collaborative Care can substantially extend the treatment reach of scarce behavioral health prescribing clinicians,” said Andrew Carlo, M.D., vice president of health system integration at the Meadows Mental Health Policy Institute and a co-author of the study. “We look forward to working with our clinic and health system partners to realize this transformative potential of Collaborative Care throughout Texas and nationwide to reduce the impact of workforce shortages, mitigate treatment disparities and significantly increase access to evidence-based health services for adults and children, especially in underserved communities.”

Despite its proven effectiveness and financial stability, implementation of the Collaborative Care Model has been frustratingly slow, due in part to worries about start-up costs associated with implementation.

To help address this barrier, members of the U.S. Senate and House of Representatives have introduced the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, S. 1378/H.R. 3519. The COMPLETE Care Act would improve access to behavioral health care in the primary care setting by incentivizing providers to implement integrated care models, such as the Collaborative Care Model.

“Expanding access to the Collaborative Care Model nationally is one of the single most important things we can do to improve and save countless lives for people struggling with depression, addiction and other mental health concerns,” said Andy Keller, president and CEO of the Meadows Mental Health Policy Institute. “Most mental health conditions are fully treatable when detected early, and the Collaborative Care Model improves the ability to detect and treat mental illness as soon as symptoms begin. This is especially important for youth and young adults, as most mental health conditions emerge then.”

Read and download the study, here.