The Script: $1.8 million grant will enhance interprofessional training

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Five Grand Rounds sessions this fall expected to include mental health counseling students

Illness not only affects patients physically, but oftentimes mentally as well.

“For example, patients with congestive heart failure have high rates of concomitant anxiety and depressive disorders. If their mental health conditions are poorly treated, it can lead to faster disease progression and higher health care costs,” says Abbie Burka, The College of Pharmacy & Health Sciences director of interprofessional education.

Despite those greater costs, and despite the health care community’s current efforts to tear down walls between professions to provide holistic health care for patients, mental health is still often forgotten in the care plan. However, a new partnership between Lipscomb’s psychology department and the health sciences college is working to change that for Lipscomb-trained health professionals.

A $1.8 million grant, the largest grant in Lipscomb University history, will fund behavioral health trainings for mental health counseling students, health science students and working professionals throughout the next four years, encouraging Nashville’s health professionals to incorporate mental health treatments into overall patient care.

The grant, awarded by the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, to Lipscomb’s Department of Psychology, Counseling and Family Science, will also fund mental health counseling interns placed on-site in primary care offices, especially those serving disadvantaged populations.

“When a patient has a need, particularly those among underserved populations, they often go to their primary care physician first,” said Douglas Ribeiro, associate professor of psychology and project director of the Lipscomb Initiative for Behavior and Health Integration. “By integrating counselors into the traditional primary care physician offices, the counselor and the physician can collaborate on-site about how to best serve the patient and to provide the needed care right away.”

As part of the initiative, mental health counseling students will now be included in the health science college’s 2018-2019 Grand Rounds programs, a program required for all student pharmacists, student nurses and graduate and undergraduate nutrition students that meets five times per semester to build teamwork and communications skills, learn about each other’s disciplines and collaboratively assess patients and create care plans.

“Collaboration by interprofessional teams to create a personalized care plan for patients, which considers their mental health as well as social needs, leads to better clinical outcomes,” said Burka.

“So consider the case of the heart failure patient presented in Grand Rounds,” she described. “Our mental health counseling students can perform a mental health assessment to determine barriers the patient has to treatment. Our pharmacy students can look for issues the patient has with medication adherence or adverse effects from their medications. Our nutrition students can assess the patient’s dietary choices. Our nursing students spend the most time with the patient and are essential to helping gain the trust of their patients.

“They can each bring their unique professional skills and perspectives which together contribute to a holistic plan,” she said.

“One thing I have realized is that the model of professional silos and hierarchies we have relied on is helpful up to a point,” said Ribeiro. “So if you are addressing a cancer or a cold, that’s specific, and that model works.

“The problem comes when we deal with chronic disease like heart disease, diabetes or obesity. Then you need an approach that is not siloed because those presentations require different levels of expertise. Our hope is that these trainings will break down walls and help our students have a strong comfort level to approach their mental health partners in providing care.”

The integrated model promoted by the Lipscomb Initiative for Behavior and Health Integration is expected to especially address unmet mental health needs of medically underserved populations, particularly immigrant populations and residents whose primary language is not English, said Ribeiro.

Patients in these populations may have a variety of challenges when seeking behavioral health services including transportation, language, and cost, said John Allen, grant administrator for the initiative. By providing behavioral health in the primary care setting, many of those barriers are eliminated.

“Wherever they may be working, health professionals with a better understanding of behavioral health integration will take away the stigma from mental health and help patients navigate the system better,” Allen said.

In addition to the Grand Rounds program for health science students, marriage and family therapy students and psychology students will join mental health counseling students in additional trainings hosted by the initiative itself. These trainings will also be available for continuing education for working professionals.

“Mental illness affects an estimated 25 to 40% of people in our country yet health care professionals are often unfamiliar with the needs of this patient population,” said Lindsey Miller, assistant professor of pharmacy and the college of health sciences’ liaison to the initiative. “This model is to teach both professions (health care clinicians and counselors) how to interact, effectively, with this patient population and to understand the resources that each group can provide to the other.”