In the latest in a series of articles featuring OneCity Health partners, we highlight Callen-Lorde Community Health Center and their role within the OneCity Health Performing Provider System (PPS).
From its initial days as an integrated health clinic, Callen-Lorde Community Health Center, which provides health care and related services to New York’s lesbian, gay, bisexual, transgender and queer (LGBTQ) communities, saw vast demand for mental health services within their primary care clinics.
“Last year we had just two social workers stationed in our primary care clinic that assessed patients and made referrals, and they filled up quickly,” explained David A. Guggenheim, PsyD, Chief Mental Health Officer, Callen-Lorde. “We know that LGBTQ patients experience trauma at higher rates than the general population, and that they can really benefit from therapy and other mental health services.”
Callen-Lorde has since expanded their model to better meet the long-term therapy needs of patients by locating both behavioral health clinicians and psychiatric nurse practitioners within the primary care clinics.
They have moved toward a system in which a patient visits a primary care provider, who conducts an initial assessment. If necessary, a patient is then seen by a therapist for a short period of time through a warm handoff, and patients can sometimes return to primary care to continue with medications prescribed in mental health.
“There is never a gap in care,” said Dr. Guggenheim, “this all begins with, and returns to, the primary care facility.”
Through the Delivery System Reform Incentive Payment (DSRIP) program, Dr. Guggenheim believes Callen-Lorde can improve the value in their model.
“Mental health disorders aren’t like medical conditions such as diabetes, we don’t have great measurements to evaluate patient outcomes. Through DSRIP, we are trying to improve the value of the care patients’ receive by renewing our focus on quality. DSRIP initiatives can help us improve by connecting us with other programs and to help us follow patients to ensure they receive the services they need in a timely manner.”
For our OneCity Health partners that are just beginning to integrate behavioral health with primary care, Dr. Guggenheim recommends a commitment to change throughout the organization. For example, Callen-Lorde recently committed to integrating mental health into all medical team meetings. Meetings are often facilitated by care coordinators with mental health experience to demonstrate the commitment to a new culture.
It is also necessary for an organization to understand and tailor care to each unique set of patients. For example, Callen-Lorde is the largest provider of trans-healthcare in the country, and ensures this community, which faces unique mental health challenges, receives appropriate care right from the start.
“We make sure patients of trans experience feel safe and supported coming to our clinic. We use the right pronouns and ask the right questions in the primary care setting,” said Dr. Guggenheim. “If patients don’t walk into a culturally competent clinic, there is a much higher risk that they won’t receive care.”