In the United States healthcare system, it is estimated that up to 85% of primary care medical visits involve psychological symptoms, including depression, anxiety, panic, sleep disruption, and/or physical symptoms such as fatigue and pain that are associated with depression and stress.
While these statistics are now considered “old news” among knowledgeable medical providers, our healthcare system has not widely implemented screening and assessment practices to identify mental illness and chronic stress in patients.
When we visit almost any medical provider, we complete a medical history in the intake process, and at each visit, someone captures measurements of our vitals to assess our general health, identify warning signs of disease, and measure progress towards recovery from illness. The US Preventative Services Task Force (USPSTF) recently published recommendations for every patient 18 or older in the US to be screened for depression in primary care. Additionally, pregnant women or new mothers were also called out as a special population that should be screened universally for depression in the primary care environment. Despite this pressure to improve quality of care, primary care providers cite multiple barriers to implementing a universal screening protocol in practice. One of the most commonly cited barriers is related to the behavioral health workforce. Integration requires a change in culture, clinically, operationally, and financially, and a change in professional identity. To integrate systems that have been siloed for so long requires well-trained leaders who are able to navigate these three worlds.
Drs. Nicholas and Janet Cummings created the Doctor of Behavioral Health degree program in 2007 to fill the educational gaps they saw in the training of healthcare professionals; namely that behavioral health providers are not traditionally trained to work side-by-side with their medical colleagues as a team. Education and training for behavioral health providers does not prepare these professionals to treat patients with chronic medical conditions; a population which is at significantly increased risk for comorbid mental illness. Similarly, Drs. Cummings noted that primary care providers are not trained to identify mental illness and substance abuse in their patients. Patients are able to access medical treatment for asthma, diabetes, hypertension, and heart disease, but the psychological components of these diseases were left untreated.
Ten years later, the Doctor of Behavioral Health program at Cummings Graduate Institute passionately and fiercely addresses those training gaps by delivering direct instruction, developed by practicing Doctors of Behavioral Health, for the integrated care professionals of the future. Each assignment in every course is directly tied to essential competencies for Doctors of Behavioral Health, so that students learn today what they will apply in practice tomorrow in their clinical settings.
This week, in our course focusing on clinical improvements for Older Adults, students pitched clinical pathways they developed to address and improve screening, assessment, and treatment for cognitive decline in primary care settings. Students are only given 10 minutes to pitch their proposal, and they must cover the critical elements of their pathway as if they are presenting to decision makers in a clinical practice. After the webinar, Dr. Larry Ford, a key CGI faculty member, commented on the critical knowledge our students have gained in the program. He shared that he pitched a clinical pathway for COPD readmissions to the VP, CNO of nursing, Internist, ER, and Pulmonary, and he only had 10 minutes on the agenda. Dr. Ford stated that everything he heard in the student pitches in that webinar is what is needed in healthcare, and that he was proud to see our students so well prepared to go out and tackle the need!
For more information on the statistics cited in this article or additional examples of how CGI students are prepared to disrupt healthcare with innovative, effective solutions, contact Dr. Cara English, Director, DBH Program.
