Integrated Behavioral Health Program
PCC has received funding from the Hogg Foundation for Mental Health and St. David's Community Health Foundation to provide Integrated Behavioral Health Services to adult patients of the clinic. The goal of the Integrated Behavioral Health (IBH) program is twofold--to provide effective, evidenced-based behavioral health services to patients with mental health issues, while also increasing the expertise and comfort-level of primary care providers in addressing mental health concerns.
The IBH program utilizes a team-based approach in which the Primary Care Provider, the Behavioral Health Specialist, the Consulting Psychiatrist and the Patient establish an individualized care plan for each patient, and track that patient's progress until mutually-set goals for improvement are met.
Through the IBH program, patients are eligible to receive psychotropic medications through their Primary Care Providers, care monitoring and the option of psychotherapy with the Behavioral Health Specialist. Patient progress is monitored on an ongoing basis, using standardized measures for tracking symptoms of depression and anxiety. The Hogg Foundation provided a clinical database that enables the Behavioral Health Specialist to track patient progress.
The St. David's funding has enabled the PCC pharmacy to add medications to the formulary that are used to bridge the gap between the time the patient first receives a prescription and reaches a stable dose and the time the patient can receive medication through the Patient Assistance Program.
The IBH program is available to existing PCC patients, and the clinic's social workers screen patients for the IBH Program. Patients in the IBH program are primarily treated for diagnoses of depression and anxiety.
Program Coordinator Contact Information
Megan Barnes Zesati, LCSW (Biography or Spotlight Article)
Behavioral Health Specialist
Visit the sponsors of this program
Staff Spotlight on: Megan Barnes Zesati
If there is a heart of the Integrated Behavioral Health (IBH) Program, it's social worker Megan Barnes Zesati. Megan's personal, ongoing contact with over 150 patients is what's allowing many to get the help they need in order to get better.
Megan describes her connection with patients as a gift. She says that "contact is what truly brings me to life at work ...simple human connection is so vital-not just for my patients, but for all of us. I feel privileged to accompany our patients in their healing, as these are important moments in their lives." Each day Megan provides therapy and case management to Clinic patients. Through in-person and telephone follow-up, Megan tracks each patient's progress and ensures that they feel cared for and listened to as they seek treatment with medications and/or psychotherapy.
To date, 71% of patients in the IBH program have decreased symptoms of depression and/or anxiety by at least 50% within 10 weeks. This is no small change. A patient whose depression symptoms are cut in half functions better and begins to enjoy life. They may get a job whereas before they were unemployed, or they may recover the energy and esteem to leave an unhealthy relationship. They are more integrated into their community and better able to manage major life stressors such as poverty and health problems.
Patients' rapid recovery is due in large part to Megan's regular check-ins. She gets patient feedback about how they're doing and about their medication. The time when patients begin psychotropic medications can be very challenging for a person already dealing with the symptoms of mental illness. It may take weeks for a medication to take effect, and patients may be concerned by side effects; it is a time when patients need encouragement and support. If a change in medication or dosage is needed, Megan knows and can make that happen.
Megan joined the staff of People's Community Clinic in September, 2006, motivated by her growing interest in the connections between mind and body. While a medical clinic is an obvious setting in which to explore these connections, Megan says she was convinced People's was the right place for her during her interview. "It just felt right," she says. "The clinic had a good reputation for taking on new ideas and programs. More importantly, what keeps me here is that I work among really good-hearted people, both my co-workers and the patients."
Megan joined the IBH program in its very first days and has appreciated the opportunity to shape the specific elements of the IBH program. For example, she found that many patients preferred the convenience of telephone calls to in-person appointments. Megan and another social worker offered a mindfulness-based stress reduction group for program participants, based in part on Megan's own experiences with meditation. "Practicing mindfulness can be very useful for those experiencing physical and emotional pain. I recommend it especially for those patients who are struggling with anxiety because people who are anxious spend a lot of time worrying about the future. Being mindful means staying in the present and simply observing one's feelings and bodily sensations without a lot of judgment."
PCC's Director of Adult Medicine Dr. Rich Peavey (biography) is one of the physicians who regularly refers patients to Megan. He does so with confidence and trust, saying, "I know I am handing my patient off to a therapist who will offer true empathy and who will treat them like a human being deserving of respect...She touches people and helps them see others ways to view their lives."
Megan's previous work experience included five years living in Oakland, California, where she worked with children and families, and one year abroad in Valle de Bravo, Mexico, where she worked at a community health clinic with adults and adolescents. In addition, Megan completed her master's level internship in Oaxaca, Mexico. Aside from making her fluent in Spanish, Megan's time in Mexico has given her appreciation for and understanding of Latino culture, which makes her especially valuable given the clinic's strong Latino patient base.
For fearlessly embracing this new program and ensuring patients have the care and contact they need to get well, we are grateful to Megan Zesati.