Framework for Enhancing Health Service Provision in Rural Settings Essay

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Integrated Behavioral Health in Rural Communities

Integrated behavioral health involves working with a primary care physician, a medical specialist and a team of people to bring the best care possible for a patient. This is important when viewed from various dimensions. For instance, a client in need of special care for a condition or a disease might need a team of healthcare professionals to ensure essential tasks are completed. Therefore, integrating primary care will help patients in rural communities manage their health because they learn to adapt new solutions into their everyday lives. Besides individuals being integrated, healthcare facilities and clinics work together to coordinate care for people in need (Chaple, 2015).

Framework for integrated behavioral health in rural communities

Regardless of the advancements and positive changes in the support, treatment, and understanding of mental illnesses in the rural communities, the need for improvement in the rural healthcare system cannot be downplayed. Researchers acknowledge that even though advances have been achieved in the rural behavioral healthcare, most mental health victims are still disadvantaged and not receiving proper care. In most cases, mental health disorders are as disabling just like heart disease or cancer as far as premature death and lost productivity are concerned. A study conducted in 2006 document that people with the most critical mental illnesses would die 30 years earlier than the average American citizen. If left untended to, mental disorders adults tend to experience unsuccessful relationships, lost productivity stress and a negative effect on raising a child. A comprehensive care structure must promote mental health integration that treats patients at the point of care where patients are most comfortable and uses a patient-oriented strategy to intervention. In addition, integration is crucial for positively affecting differences in health care in rural populations (Acevedo-Garcia et al., (2012).

Medical-provided behavioral healthcare model

Medical-provided behavioral healthcare is a delivery framework whereby only the medical providers are directly engaged in the service provision.

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For instance, the physicians can do simple things to deal with behavioral health problems. This may include supporting patients to use a daily diary to plan some activities, discussing an exercise schedule with depressed patients or even having a nurse to follow up on a patient through a telephone call to guarantee medical compliance (Bao, Casalino, & Pincus, 2013).

Under this framework, consultation-liaison is often used. Here, the primary caregiver delivers the behavioral health care service while a psychiatrist gives consultative support. The aim is to improve the ability of the primary healthcare provider in treating patients with behavioral health problems within a primary care setting. As the sole primary care consultant, the psychiatrist delivers care by seeing patients with the physician or advising through the telephone but s/he does not co-manage the client (Chaple, 2015).

When primary care providers are diagnosing a behavioral health issue in patients, they use evidence-based behavioral screening devices. An example of such tools is the "Patient Health Questionnaire" (PHQ-9), which is frequently used to identify people with depression. This questionnaire contains nine items that can be easily filled within two minutes. Equally, the physician affirms the symptomology of the depression. This is achieved by talking with other providers, talking with the patient or reviewing PHQ-9 scores. Then, s/he adopts brief algorithms for treatment. This practice is commonly known as screening and brief intervention (SBI). In most medical facilities, screening of depression has been integrated as a routine practice in the care for people with chronic diseases. This procedure starts with a brief two-question screening, where the first two questions of the PHQ-9 are used. Besides, an increasing number of primary care homes are screening for a multitude of issues like substance abuse, panic disorder, and bipolar disease.….....

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