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The Importance of Collaborative Care in Treating Mental Health Disorders
In Part 3 of this video series, Psych Congress Steering Committee Member, Craig Chepke, MD, FAPA, adjunct associate professor of psychiatry, Atrium Health, adjunct assistant professor of psychiatry, UNC School of Medicine, and medical director, Excel Psychiatric Associates, Huntersville, NC, takes a deeper dive into the importance of collaborative and patient-centered care when treating serious mental illness.
Watch next:
Catch up on the series:
- Part 1: The Impact of Omicron on People With Serious Mental Illness
- Part 2: Treating Serious Mental Illness Through Telehealth
Read the transcript:
Craig Chepke, MD, FAPA: Another important topic we addressed is the collaborative care model. People with SMI (serious mental illness) we've found pretty unequivocally in the past few decades have greater rates of medical comorbidities, as well as psychiatric comorbidities than people in the general population. So it's important for there to be a collaborative approach. Unfortunately, many people with SMI don't get the kind of medical care that they really need to address their medical comorbidities. The collaborative care approach can really help to allay some of these issues and ameliorate them.
So the collaborative care model really looks at trying to bring together providers from different specialties. It could look a number of different ways. It could look like a mental health clinician being embedded in a primary care clinic, it could be the opposite. It could be a primary care provider being embedded in a psychiatry clinic in the clinic. And there's many different variations. It could just mean having a greater verbal collaboration between the different clinicians, but really making sure that the patient doesn't fall through the cracks because in the collaborative care model, we put the patient at the center of everything and we all work together as a team surrounding them. So it involves the higher level prescribing clinicians, but also therapists and counselors, case management, social work, really the entire multidisciplinary team is part of this collaborative care approach.
And of course, we can't forget families. Oftentimes in certain models of training, certain training programs, we're taught that the patient should be at the center, but they should kind of stand alone. And that in some ways, collaborating with family, friends of the patient can be discouraged in some ways. But I think and there's evidence to back this up, that when we bring family members into the treatment that the outcomes do tend to get better.
I did have a fair amount of training in the family care model and I've continued to use that in my practice. I'd say almost three quarters or more of my patients are seen with some family member or another, obviously with their consent. When I explain to patients that this is not because I don't trust you and what you're telling me, but it's kind of like going from two dimensions to three dimensions when I go from having just the patient in the room to having a patient and a close friend, a confidant, a family member, in the room with them. I can see things from so many more perspectives and the more information I have, the better I'm able to help you. That goes over extremely well.
Furthermore, it helps the family to better understand what the person with the illness is going through and decreases the likelihood that they're not going to be able to help the person because psychoeducation is very difficult to come by other than directly from the source. There's a lot of incorrect or misleading information on the internet or in other sources that patient family members might look at.
So bringing them in, make sure that everyone's on the same page. When I tell a patient something about the illness, the diagnosis, the prognosis of treatment, then the family hears it at the same time. It's not weighed upon the patient's doorstep that they have to now go and explain, "Well, this is what the doc said. This is what he thinks might happen with the medication." Everyone's on the same page at the same time and so it reduces the amount of miscommunication.
And also I'm only—or any mental health professional—is only with the patient a short span of time and not frequently enough. Whereas family members, friends are often in much, much closer communication, potentially living together with the patient and they can be the cheerleaders for the patient. They can reinforce certain coping skills. They can hold them accountable for homework that we might as clinicians give them to undergo certain tasks that are leading to, we hope, better outcomes for them.
So overall, putting the patient at the center of the solar system and we all revolve around the patient, whether we're clinicians, ancillary healthcare, staff members, or family and friends of the patient.
