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Behavioral health available at primary care clinics

Air Force News Service

Published: 12:00PM May 29th, 2014

Airmen, dependents and veterans now have access to behavioral health services through their primary care manager, or PCM, at any military treatment facility, Air Force Medical Operations Agency officials report.

The Behavioral Health Optimization Program, or BHOP, uses psychologists and social workers as consultants working directly in the primacy care clinics. They are known as internal behavioral health consultants or IBHCs, said Maj. Matthew Nielsen, the chief of BHOP.

The program was created in 1997 as an Air Force pilot program and received limited funding in 2008, Nielsen said. In fiscal year 2012, the program was implemented across the DOD and has proven to be an effective model of treatment and has already seen a lot of success.

“The program focuses on providing the right care, at the right time and in the right place and helps to fight the mental health stigma,” he said. “Many patients aren’t willing to go to the mental health clinic, but they are willing to discuss their concerns during primary care visits.”

In fact, research suggests that more than 50 percent of all behavioral health disorders are treated in primary care exclusively, and 67 percent of people who may have behavioral health problems do not get treatment at all, officials said. By providing this care in the primary care clinic, BHOP reaches a larger Air Force population and increases access to those who might not otherwise seek assistance.

“Research has demonstrated that BHOP is a very effective model and we are seeing a lot of patients in primary care,” he said. “Patients are getting better and they report being highly satisfied with these services.”

According to Nielsen, the implementation of BHOP into treatment facilities was not created to eliminate the need of mental-health clinics. The program operates on a separate model providing what he refers to as a “stepped-care approach.”

“BHOP is not mental health treatment or psychotherapy,” he said. “We don’t go into the amount of detail and depth (of treatment) that mental health clinics do. We focus on behaviors, habits and things you can do right here and now to improve whatever symptom or condition you are experiencing."

“BHOP is a brief intervention model,” Nielsen said. “We see patients three to four times, and our appointments are typically 20 to 30 minutes long. If you need help beyond that, the IBHCs will place a referral for the patient to go to a mental health clinic, either on base or in the community.”

Some of the major conditions the BHOP program provides services for are: depression, anxiety, panic disorder, tobacco use, alcohol misuse, diabetes, obesity, insomnia and chronic pain.

“Not all patients require the intensity and level of care that mental health clinics provide,” he said. “Research has demonstrated that many patients can make significant improvements within this brief model of primary care behavioral health."

Though much of the focus of the program has historically been placed on the PCMs and the IBHCs, Nielsen says the program also now incorporates nurses, also known as behavioral health care facilitators, or BHCFs, to help facilitate care for patients who are treated with medications for specific mental health conditions like depression, anxiety or PTSD.

“If a PCM prescribes medication for depression, anxiety or PTSD, then the BHOP nurse will contact the patient via the phone, once a month, just to check on them to see how they are doing, if they are experiencing any side effects and to assist them in scheduling PCM follow up appointments as necessary,” Nielsen said.

“We have found this to be an effective model as research has proven patients’ symptoms improve more rapidly when someone contacts them regularly throughout the treatment process,” he said. “Also, patients really like that contact because they feel like, ‘the team really does care about me,’ while helping them access resources they need, as they need them.”

“Airmen and commanders should know that this is another resource for them to access behavioral health care,” he said. “The program provides behavioral support for all kinds of conditions. Airmen and their families just need to drop in and ask their PCM about it.”