Background & Goal
Approximately 73% of patients seeking primary care have a psychological or behavioral health component connected to their chief complaint, and that percentage increases for patients with a chronic disease. When Dr. Reiss-Brennan opened her independent nursing family therapy practice in 1978, she received a regular stream of patient referrals from primary care providers uncertain of how to address their patient’s mental health needs. In 1984, to respond to this gap in care, Dr. Reiss-Brennan developed a collaborative, innovative business model to train primary care providers/clinics in mental health care and family systems concepts.
Dr. Reiss-Brennan’s innovative mental health integration care model caught the attention of Intermountain Healthcare (IH), and in 1998, Dr. Reiss-Brennan’s care model was coupled with a model on chronic medical diseases to lay the infrastructure for Mental Health Integration at Intermountain Healthcare, Utah (MHI). Through this pilot integrated care model, depression, substance abuse, anxiety and other mental health conditions were managed in IH primary care settings alongside other chronic conditions. In 2001, following the extremely positive outcomes of the pilot program, IH requested Dr. Reiss-Brennan to join their team and diffuse MHI throughout the entire delivery system.
The MHI model of care is designed to promote three essential primary care practice changes: 1) improve the detection, monitoring, stratification, and management of depression and other mental health and medical conditions; 2) reinforce ongoing relational contact with patients and their families to promote adherence and self-management; and 3) match and adjust treatment and management interventions if there is evidence of increasing complexity and/or inadequate patient response. The broad goal is to involve the patient and family in their own care and to enhance their self-management skills.