Grants support integration

By Rivkela Brodsky
March 1st, 2015

Ten organizations in Massachusetts have been awarded $1.3 million in funding to support work integrating behavioral health and medical care.

The new grant program of the Blue Cross Blue Shield of Massachusetts Foundation, called Fostering Effective Integration of Behavioral Health and Primary Care, provides one-year funding to community health centers, community-based behavioral health centers and hospital-based programs in the state that are already doing work in this area.

The idea is to spend a year looking at how these organizations are addressing the issue of comorbidity to assist the foundation in creating guidelines for a three-year grant in this area, said Audrey Shelto, president of the foundation.

“They are organizations who have been doing this at various stages and are quite far along in the continuum of having fully integrated services,” she said. “We wanted to understand what can we learn from them and while we support their programs for this year, help us narrow our focus to invest dollars in a way that is going to advance the field.”

She said the behavioral health and primary care communities have for decades known that there needs to be more synergy of care between the two fields.

“There is such an interplay between behavioral health conditions and medical conditions, particularly chronic medical conditions,” Shelto said. “From a patient perspective, it’s much, much harder in either direction. If you have a severe behavioral health issue it’s hard to manage a chronic illness and if you have a chronic illness, it’s hard to manage any mental health issue you might have.”

The news release announcing the grants includes these numbers from Harvard Medical School’s National Comorbidity Survey Replication: 68 percent of adults with a severe behavioral health disorder had at least one chronic medical condition and 29 percent of adults with a chronic medical condition have serious mental illness.

Those dealing with a mental illness live far shorter lives than those without, partly due to treatable medical conditions and inadequate access to medical care, the release reads.

Grants range from $125,000 to $150,000 and went to programs in Boston, Cape Cod, Worcester and western Massachusetts.

Organizations receiving the funding are using it to continue or enhance care, said Celeste Lee, senior director of grant making at the foundation. That might include hiring employees or collecting data.

The Center for Human Development will be using its $125,000 grant to collect and analyze data on a program that connects adults dealing with a serious mental illness to a primary care provider at its locations in Springfield and Holyoke, said Jennifer Higgins, Ph.D., director of compliance and quality assurance for the organization.

It will also allow the center, which serves homeless families, at-risk youth and seriously mentally ill populations, to host a leadership summit on integrative care in the fall, she said.

“This was something we really wanted to do and we didn’t have the resources to do that until we had this grant money available to us,” she said.

The Cambridge Health Alliance was awarded $125,000 to continue its work connecting children with mental health and substance abuse issues to primary care providers Windsor Street Clinic.

The program has been using a Collaborative Practice Model, developed in 2011 by Katherine Grimes, M.D., director of the Children’s Health Initiative for the alliance, Gregory Hagan, M.D., chief of pediatrics for the alliance, and Benjamin Cook, Ph.D., senior scientist at the alliance’s Center for Multicultural Mental Health Research.

The alliance has had success with its program, which works with mostly immigrant-based populations who face language, cultural and economic barriers, said Grimes, who is also an associate clinical professor of psychiatry at Harvard Medical School. That includes a lower no-show rate, increased follow through on recommendations and a reduction in emergency room use and expense, she said.

The grant allows the alliance to keep the programs going. “It is like a bridge loan, an interim chance to continue,” Grimes said.

The funding will also allow the alliance to establish programs to support parents dealing with mental health issues, pay for physician and mental health care providers’ time for meetings on integrative care, and pay for a research analyst to focus on this program.

“The funding is really all for people,” Grimes said.

Other organizations receiving the grant are Boston Health Care for the Homeless Program, Brookline Community Mental Health Center, Community Health Center of Cape Cod, Community Healthlink Inc., Dimock Community Health Center, Lynn Community Health Center, UMass Memorial Health Care Inc., and Vinfen Corporation.

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