| PCC | BHC | Consulting Psychiatrist |
|---|---|---|
| Open to sharing care with others: recognizes that other professionals bring specialized expertise | May proactively review patients to identify potential needs/opportunities for BHC services to PCC | Views role as adjunct to PCC and BHC, not as the replacement |
| Participates in briefing by listening and asking for clarification when needed | ||
| Reviews screenings, uses clinical discretion, or considers suggestions to identify patients needing BHC services | Introduces self as a member of the care team: normalizes behavioral health care delivery as part of “routine” practice | Introduces self as a member of the care team |
| Provides brief assessment of patient's behavioral health needs and establishes foundation for BHC handoff: describing expertise, importance of whole person care, expectations (“selling” resource to patient) | Conducts rapid, targeted assessments of patient needs; identifies “feasible” targets for brief intervention | Provides psychiatric consultation to the primary care team as needed |
| Briefs BHC on perceived patient condition/needs: assessment of situation, depression intervention | Sets agenda balancing patient/PCC priorities, or negotiates focus of these two stakeholders | Assists PCC: diagnosis, treatment planning, and recommendations |
| Available to debrief with BHC during encounter or post-encounter to develop care plan | Apply brief interventions using abbreviated evidence-based treatment strategies: solution-focused therapy, behavioral activation, cognitive behavioral therapy, motivational interview | Willing to treat/consult on some patients without seeing them |
| Reinforces care plan and/or BHC intervention during next encounter | Clinical capacity to address full spectrum of behavioral health needs: common mental health conditions (depression, anxiety), lifestyle behaviors (self-care, social engagement, relaxation, sleep hygiene, diet, exercise) | Makes a treatment plan in a short amount of time with limited information |
| May develop specialization areas: substance use counseling, biofeedback | Focuses on complex patients who cannot be managed alone by PCP and BHC | |
| Links efforts to overall patient care: reinforce care plan with PCC and summarize goals/next steps with patient | ||
| Leads group sessions for patients: pain groups, diabetes management | Engages other professionals in patient care plan: BHC, social worker, pharmacist | |
| Determines care level needed: additional followup with BHC, transition to specialty mental health care | Coaches PCCs to manage complex patients; transitions patients back to primary care | |
| Assists with specialty mental health/other treatment resource transitions (case management) | ||
| Concisely communicates information to the primary care team: verbally, EHR notes | Concisely communicates information to the primary care team verbally, EHR notes |
BHC, behavioral health clinician; EHR, electronic health record; PCC, primary care clinician.