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ASCENT Program Positions CMHCs in New Mental-Health and Primary-Care Integration Initiatives

By Joel E. Miller
AMHCA Executive Director and CEO

AMHCA is pleased to announce a bold new initiative to engage and assist members on mental health and physical healthcare integration through the AMHCA Strategic Counselor Engagement and Network Technology program—the ASCENT program. 

Due to the incredible interest in the articles that appeared in the April issue in the Journal of Mental Health Counseling (JMHC) on “Mental Health in Primary Care,” the contributors to the April Journal will partner with CMHCs and other practitioners to help counselors find innovative ways to translate the recommendations in the Journal articles into everyday practice and to engage primary care physicians and specialists. Researchers and practitioners in this virtual community will have the opportunity to discuss new mental health and primary-care integration ideas, and translate those 

strategies into innovative ways to implement the recommendations in the JMHC articles.

This effort will be part of AMHCA’s Forum for Learning Opportunities and Working Technical Assistance Collaborative (FLOW-TAC)TM, an electronic forum for sharing and learning about new and successful care-delivery arrangements that address the needs of AMHCA members. Through shared learning, CMHCs will work with each other—and Journal contributors—to test and implement changes that lead to lasting quality and patient-care improvements.

The ASCENT initiative presents an initial major opportunity to develop a comprehensive and integrated learning community approach to connecting Journal contributors to clinical mental health counselors by facilitating research findings into timely practice (i.e., a 

Earn 2 CEs for
Each Two-Hour “Conversation Starter”

Earn 2.0 CEs for every two-hour Conversation Starter webinar you attend. The Conversation Starter sessions areFREEfor AMHCA members, and each one runs from 12 p.m. to 2 p.m. EDT.
  • Dates for the upcoming Conversation Starters are July 31, Aug. 19, and Sept. 11, 2014.
  • Get more information about the ASCENT events and register.
  • Read the April 2014 JMHC Special Issue on “Mental Health in Primary Care.”
    • Members have FREEaccess to the issue through March 2015.
    • The nonmember download fee is $20 per article.

journal-facilitated, scholar-practitioner network). Similarly, practice efforts will inform future research projects (i.e., translating practice to research). 

The Integration Imperative

The integration of mental health and primary care (as well as substance use services) is a promising solution to system fragmentation (individual care delivery silos). It’s also an opportunity to address:

  • Mental illness prevention,
  • Mental health promotion,
  • Early intervention, and
  • Continuing, coordinated care practice developments aimed at improving mental health outcomes and reducing the disease burden of behavioral health conditions.

The research shows that integrating behavioral health and primary care poses the best shot at slowing down the rate of escalation in healthcare costs—bending the cost curve—that has been to a significant degree driven upwards by ineffective but expensive care for individuals with chronic co-morbid health conditions.

The new emphasis on integration represents a major opportunity for clinical mental health counselors. Both primary and specialty settings need, now and in the future, to play a major role in leveraging change in three core drivers of morbidity, mortality, and cost:

  • Delays between disease onset, diagnosis, and treatment;
  • Unaddressed co-morbidity of mental health and substance use disorders; and
  • Fragmented and uncoordinated care for co-morbid physical and behavioral health conditions.

The Launch—Engaging CMHCs

Journal authors will engage the clinical mental health counseling profession and provide general technical assistance to CMHCs on a critically important area—namely, mental health and primary care integration—and how they can prepare themselves for future innovative patient care and delivery mechanisms.

The April 2014 Journal authors will discuss their findings and recommendations—from the articles developed for the Journal—to CMHCs and other practitioners through an initial set of virtual sessions created and funded by AMHCA focusing on major themes of the journal articles from the April 2014 issue of JMHC:

  • July 31: Conversation Starter Session—How to Get Started: Gaining Basic Competencies on Integrated Care and Training in Primary Care Settings. Presenters for the July 31 Conversation Starter include:
    • Psychologist Mark E. Vogel, PhD, the director of Behavioral Science and Psychology within Genesys Medical Education Department in Michigan, and an associate professor at Michigan State University, in the College of Human Medicine. Within the Society of Behavioral Medicine, he was elected chair of the Integrated Primary Care special interest group in 2012.
    • Eve M. Adams, PhD, an associate professor and director of Training for the Counseling Psychology PhD Program at New Mexico State University. In addition to serving on the editorial boards of two scholarly journals, she has received large federal grants, used mainly to train counseling psychology students to provide behavioral health services in primary care settings.
    • Jared Cox, PhD, a licensed psychologist currently working for the Veterans Health Administration as a Health Behavior coordinator and Primary Care-Mental Health Integration (PC-MH) team member. He also provides consultative services to New Mexico State University’s Counseling Psychology Department regarding its primary-care Psychology curriculum and staff education efforts.
  • Aug. 19Conversation Starter Session—Carving Out an Integrated Care Niche: Cultural and Linguistic Competencies and Tailored Care
  • Sept.: 11: Conversation Starter Session—New Collaborative Models: How to Work with PCPs to Address the Needs of Clients with Co-Morbid or Complex Conditions (e.g. Diabetes, Alzheimer’s)

Follow-Up Interactive Dialogue and Implementation

The following interactive or “engaged continuous network” process will take this effort to a new level of dialogue among AMHCA members and JMHC authors as well as other stakeholders, using new interactive technologies:

  • After the three Conversation Starter Sessions conclude in September,Cross-Segment Working Groups of AMHCA members will meet monthly—or on a regular basis through an AMHCA collaborative-group virtual technology. Meetings will be avenues to discuss and address real-life technical issues confronted by practitioners in implementing and participating in integration efforts (e.g., operational barriers working group, payment approaches/financial incentives working group, cultural competency working group, etc.).
  • The initial discussions will encourage participants to present “ASCENT Ignite” strategies and tools that can be used by participants to implement new ideas in their locales and practices. These fast-paced presentations will enlighten AMHCA members, will be quick to grab their attention, and can be put into action.
  • The Cross-Segment Working Groups will also have the ability to track, benchmark, and extrapolate from others’ efforts, providing a valuable source of “what works” and lead to ideas for other projects to develop integration approaches. This process will allow potential opportunities to partner with key stakeholders and create “learning laboratories.” These learning labs may further refine best integration practices from which the entire mental health sector could benefit.
  • Roundtables would then be created, which will comprise appointed AMHCA members designated from the Cross-Segment Working Groups to share lessons learned and report back to a “Virtual Expert Support Team (VEST)” comprised of the April 2014 Journal contributors and other AMHCA officials in a new and continuous “practice to research” feedback loop. The Virtual Expert Support Team will meet bimonthly for a two-hour session to engage the roundtables.
  • Publications will flow from these discussions and other conversations and be disseminated to all AMHCA members and other mental health professionals. The publications will highlight findings such as successes, problems, and the potential development of best practices in integrating mental health and primary care.
  • A follow-up AMHCA publication will be released that identifies new strategies and approaches by the April Journal contributors and lessons learned. It will also identify successes where AMHCA members have instituted the initial Journal’s recommendations, and tailored those recommendations for local and specific integration practices—another feedback loop or double loop.

We are excited about the opportunity this new interactive process gives to AMHCA members to maintain a continuous dialogue on mental health integration among CMHCs and with experts in the field. 
We hope you take the time to participate in the three Conversation Starters and the interactive process that follows, beginning in September.

Join the ASCENT initiative. 
Your future depends on it!