by Jason Webb

As the pandemic swept across the country, a team of mental health professionals embedded in local medical clinics witnessed a historic increase in patients in need of behavioral health care.

The Health District of Northern Larimer County’s Integrated Primary Care and Mental Health Program, in partnership with Salud Family Health Center and the UCHealth Family Medicine Center (FMC), has seen significant demand for its services.

“The demand is unreal. I have never seen anything like this before,” says Andrea Holt, the program manager and a licensed marriage and family therapist. “In October or November of 2021, we implemented a waitlist for patients wanting to schedule a therapy appointment.”

And there is no sign of a slowdown, either.

Between the two clinics, five full-time behaviorists and one part-time behaviorist have seen 1,000 patients and spent a total of 3,000 hours providing care over the first half of 2022. (A behaviorist addresses a person’s mental state as well as their physical condition, and may provide treatment for mental health issues including substance use concerns.) This unique program, begun in 2005, allows Health District behavioral health specialists to collaborate with primary care physicians to provide complete patient care at FMC and at Salud Family Health Center on Blue Spruce in Fort Collins. Psychiatrist Dr. Zeljko Ivanovic provides consultations for providers and clients at both locations, and works with a family practice resident at FMC to facilitate learning for the resident physicians.

A waitlist is nothing unusual for mental health services. According to a survey by the American Psychological Association, nearly 7 in 10 psychologists who have a waitlist have seen it grow since the start of the COVID pandemic. But the integrated health model makes it is easier for individuals to see a behaviorist when they need one.

Here’s how it works: A patient schedules an appointment with their primary care doctor. If the patient wants to see the behaviorist, they can ask to see them; or a doctor can call the behaviorist in if they think the patient needs the help. The collaborative nature provides more complete care, but the work is different than ordinary therapy.

“A behaviorist who is integrated has to function differently than they would in a typical clinic setting,” explains Holt. “It takes different skills.”

A behaviorist may be speaking with a patient while a laboratory technician comes into the room to do a blood draw. Or, the behaviorist may get paged by a doctor to consult about another patient mid-consultation. They are often on the move.

Family Medicine Center medical residents are getting exposure to behavioral health specialists, too. Dr. Janell Wozniak is the FMC residency program director. She says many resident physicians are drawn to the program because of the available resources.

“These physicians-in-training are able to see patients alongside our behavioral health providers and work with them almost every day,” says Wozniak. “At the end of three years, they have the skills to support patients’ emotional needs and make important connections for those who might need additional support.”

Wozniak also points out that the behaviorists play a critical role at the center because doctors can expedite care for patients who need mental health assistance or are struggling with substance use. The integrated care team is easily available to see patients, which allows the patient to talk to a behaviorist right away. The team can also refer someone to a community provider who is accepting patients. 

In some cases, patients may believe there is a stigma surrounding seeking behavioral health. Seeing a behaviorist during the visit with their doctor can help reduce that stigma, save time for the patient, and provide care in a familiar environment.

“We strongly believe that this improves the compliance with follow-up care and appointments,” says Wozniak. “In the long run it helps our patients receive better care and have better outcomes.”

Current patients at Salud and FMC are eligible to take part in the Integrated Primary Care and Mental Health Program. To schedule an appointment at Salud, call 970-494-4040. For appointments at UCHealth’s Family Medicine Center, call 970-495-8800. Patients at both locations can also make a request through their primary care team.