Christiana Care is leading innovation in behavioral health services in the state and increasing access to mental health services for all Delawareans. That was the message presented by Sharon Kurfuerst, Ed.D, OTR/L, FACHE, senior vice president, health services operations, and Linda Lang, M.D., chair of the Department of Psychiatry, Feb. 3 at a meeting of the Behavioral and Mental Health Task Force in Dover.
“Our many innovations in the outpatient and inpatient settings provide care to the whole person, body and mind, and support our shared goal of the State Innovation Model to make the First State one of the five healthiest in the nation,” Kurfuerst said.
Christiana Care’s successful integrated behavioral health model — embedding therapists within specialty and family medicine practices — is expanding access to care and opening mental health doors to many children, adolescents and adults in our community who might otherwise never seek help, she said. Since November 2014 when Christiana Care began integrating behavioral health consultants in 11 primary care practices and one specialty care practice, the team has seen more than 3,100 patients for a total of more than 8,500 sessions.
“To support the integrated model, Christiana Care recently hired four new behavioral health consultants, including one at the Smyrna Health & Wellness Center and one at the Middletown CareCenter,” Dr. Lang said.
Mental health experts in Christiana Care’s Adolescent Bridge program work with teens to address anxiety, depression, stress, anger management, relationship conflicts and other issues. Teens also join group sessions to learn about emotional health, communicating effectively, making sound decisions and dealing with stress and peer pressure. Since March 2015, there have been 75 new teen patients with 300 patient visits.
Helping people to overcome addiction
Among the innovations to inpatient care, Christiana Care’s Behavioral Health Service Line integrates care at the bedside and continues to add programs and resources to treat patients with substance abuse disorder, which is a growing problem in Delaware and nationally. For example, in March 2016 the Behavioral Health Service Line begins a pilot program to improve the care of illicit opioid-dependent hospitalized patients, including pregnant women. The new program includes screening patients admitted to the hospital for risk of opioid withdrawal and the use of standardized protocols to monitor and treat withdrawal.
“By 2018 Christiana Care will expand the inpatient psychiatry unit from 24 to 30 beds at Wilmington Hospital to provide acute medical services to patients with psychiatric illness,” Kurfuerst said.
With Project Engage, Christiana Care’s early intervention program that helps substance-using hospital patients connect with community-based treatment programs, nearly 4,500 patients at inpatient units and emergency departments of both Christiana and Wilmington hospitals received care. Project Engage has led to an increase in patients who enroll in community-based drug-treatment programs and a reduction in 30-day readmissions among patients with substance-abuse problems.
To help address immediate behavioral health concerns at both Christiana and Wilmington hospitals, Christiana Care is creating a Behavioral Health Rapid Response Team.
“This team will be comprised of behavioral health professionals, including nurses, psychiatrists and mental health associates trained to respond to staff and patients who require immediate attention to address a psychiatric situation in the hospital,” Dr. Lang said.
Helping women overcome postpartum depression
Through the Center for Women’s Emotional Wellness, Christiana Care supports women planning to become pregnant throughout pregnancy, delivery and the first year after birth with outpatient therapy and medication management. In 2015, the team consulted with 240 new mothers in the hospital immediately following delivery and conducted 2,750 outpatient visits. Christiana Care screens all new mothers for mood and anxiety symptoms after childbirth, before they leave the hospital.
“Christiana Care understands the critical need for workforce development in Delaware to meet the behavioral health needs of our community and is taking measures to train the next generation of behavioral health professionals,” Kurfuerst said.
Beginning in 2017, a Psychology Internship Program will integrate psychologists in outpatient and inpatient settings throughout the health system to receive training. In 2018, a Behavioral Health Residency Program will begin training psychiatrists.
“By receiving training and experience in behavioral health at Christiana Care, these newly trained experts are more likely to remain working in the state and help alleviate the shortage of trained professionals,” Kurfuerst said.
Building a community of care
Christiana Care remains committed to continue working with stakeholders in the state to advance the shared goals of improving behavioral health and providing greater access to care. Last October, Christiana Care hosted a Behavioral Health Summit that brought together about 50 thought leaders from the public and private sectors — state agencies, health systems, behavioral health facilities and practices, nonprofit organizations, patient and family representatives and law enforcement — in what is believed to be the first such statewide focus group to examine the various touchpoints throughout Delaware’s behavioral health system.
“The aim is to advance a holistic framework that produces healthier outcomes for individuals and communities,” Kurfuerst said. “Christiana Care also works actively in partnership with the Delaware Center for Health Innovation to advance our shared goals of improving behavioral health and access to care for all in our community.”