Since March of 2013, through a contractual relationship with the National Council for Behavioral Health, Afia has been providing integrated care consultation services in over 20 states. Often times, the training starts with a skeptical audience of case managers who are worried about how they are going to “add this on” to their already heavy workload. We have the good fortune to be living in an era of unprecedented access to medical advancements in technology and research that allow people to recover from medical conditions that less than seventy five years ago had a high rate of mortality. Despite these advances, people with mental illness have a life expectancy of of 53 years of age.
Moving from case management to a care management model is more transformational as opposed to “adding on” a service. A primary goal of the training, and the overall movement to care management is to create a culture of whole health, which includes taking a good look at the way behavioral health services are provided and determining if the services and supports offered by an agency are supportive of a culture of good overall health, as opposed to supporting the management of symptoms of a mental illness. It’s not enough to transform case management – there has to be an agency culture in place to support whole health and wellness. Other types of Integrated Health consultation Afia provides includes an overall assessment of an agency’s readiness for integrated care, working with electronic health records to measure whole health outcomes, and helping build community partnerships to support transformational change.

Kathy is a consultant and trainer with the National Council for Behavioral Health, providing integrated care consultation and case to care management training sessions across the United States. A significant part of this consultation is done in the form of a day-long training entitled, “Making the Transition From Case to Care Management.” The training curriculum, developed by the National Council, has the goal of supporting people with behavioral health needs to achieve better health care outcomes. Other participants are convinced that they are already “doing this work” so why are we talking about this as a big change? Vaccines, medications, surgical procedures and early detection of cancer and other previously fatal conditions, including those caused by injuries, have created the potential for people have longer life spans. It involves moving from directing the person to complete an application for some sort of medical coverage and making a doctor’s appointment, to having an overall understanding of the risk factors that may lead to chronic care conditions (including Obesity, Type 2 Diabetes, Heart Disease and Stroke).
Work plans created by participants at the conclusion of the training often reflect great creativity and “out of the box” thinking, which creates great potential for constructing change. Within an agency’s service array and way of doing business, there may not be support for a culture of whole health. The onsite and telephonic consultation provided by Afia through both the National Council for Behavioral Health and through Afia’s Integrated Health services can help agencies to provide more comprehensive whole health services to the needs of people with complex lives.

Kathy holds a Master’s degree in counseling psychology and has worked in the community mental health field for over 26 years. But as we begin a conversation of the overall health of the people we work with and support through their recovery journey, participants become more aware of the fact that just because people have access to healthcare, it doesn’t necessarily equate to good health outcomes.
Given the complex lives that are common in people with behavioral health needs, poverty, lifestyle and stress often create significant barriers to achieving recovery from and resilience in living with a behavioral health condition or a developmental disability. Within the behavioral health services continuum, case management has been an essential service in breaking down barriers. Within case management, creating access to medical services, including helping people obtain medical coverage and finding a primary care physician has been a strong focus, if not a state required function.

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