Psych NPs and COPD/CHF/CKD/etc clinics

  1. Out of curiosity, is anyone familiar with any clinics/programs for chronic physical conditions that really do a great job of incorporating mental health services? If so, any insight as to the nuts and bolts of how they go about it? I'm doing some clumsy googling and finding a few vague references to an "interdisciplinary approach" but nothing specific.

    Currently I'm a med/surg RN starting in a psych DNP program in the fall. I love psych, and with my med/surg background, I am really interested in how management of chronic conditions like COPD can be improved with better access to mental health services. My fantasy is a clinic model with an in-house psych provider, and I'm sure it's out there, I just haven't found one. Really I'm just daydreaming, trying to figure out how it might work. Should a mental health eval be required? How would appointments work? Same day as with the other provider? Separate? How would one coordinate care if a pt already has a psych provider outside the clinic? Yadda yadda yadda.

    Thanks for tolerating a rambling post, folks!
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    About LouBean, BSN, RN

    Joined: Jun '14; Posts: 35; Likes: 93

    7 Comments

  3. by   elkpark
    Try Googling "PCMH," or "patient-centered medical home."
  4. by   TerpGal02
    We have this at the agency I work for. We habe the outpatienf mental jealth clinic and our agency has partnered with another agency that pdovides primary care so that they have a clinic in the same building. They do this at 2 of our locations. Its pretty great.
  5. by   LouBean
    Quote from elkpark
    Try Googling "PCMH," or "patient-centered medical home."
    Aaaah! That's the lingo I was missing. Awesome. Thanks!
  6. by   Wsmfp88
    This is the model where I work. We are a FQHC and are recognized for excellence in interdisciplinary care. We have integrated behavioral health (psychologist, psychiatry and pmhnp) and community health (case worker) in every pod of the clinic, whether that be primary care, women's health, or peds. Psych is utilized in so many different ways for us. If consult with psychiatry is needed, our behavioral health team is the patient's "in" and due to demand, will be scheduled in a couple of weeks. However, if the need is urgent, the primary care provider can consult with the psychiatrist or pmhnp to prescribe for the patient same day. In addition, we have a feeder program for patients with substance abuse problems. It truly is a fantastic model and, as others have said, is at the essence of a medical home. The downfall for us is that the need for our services is greater than our ability to provide, so we stay pretty darn busy. I figured all FQHC's were like this, but maybe not?
    Last edit by Wsmfp88 on Jan 10
  7. by   elkpark
    My city has two separate (one operated by each of the two major healthcare systems in the city) primary care clinics specifically for the chronically mentally ill, that are not intended to replace their psychiatric providers but are designed to accommodate the special needs of that population. Also, our city HIV/AIDS clinic has a large, integrated mental health component.
  8. by   xenogenetic
    This is a big trend. The term to describe it is "integrated care."
  9. by   traumaRUs
    Just clarifying: you, as the Psych DNP, would care for the psych issues? And then there would be other providers that would deal with chronic disease processes, correct?

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