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Creighton addresses psychiatrist shortage with Collaborative Care Model

Oct 26, 2021
5 min Read
Machine Learning

Exacerbated by the COVID-19 pandemic, the demand for mental health services in America is increasing at a time when the workforce in this field is aging and declining. The result is a growing psychiatrist shortage that is becoming a threat to public health.

One Creighton University faculty member is addressing the shortage with the Collaborative Care Model—a collaborative, integrated approach or team-based model that brings together primary care providers (PCPs), therapists and mental health specialists to ensure patients achieve long-term goals and do not fall through the cracks.

According to the Health Resources and Services Administration (HRSA), 123 million Americans reside in 5,836 mental health professional shortage areas in the United States. Data indicate that the U.S. workforce requires 6,430 mental health providers to eliminate health professional shortage areas where mental health disparities prevail.

While the shortage is a crisis on a national level, Omaha has more mental health patients per capita than many cities. Shannon Kinnan, MD, assistant professor at the Creighton University School of Medicine says Nebraska is in high demand for psychiatric treatment—especially for children and adolescents. She says the severity and incidence of psychiatric illness continues to climb and has been magnified by the pandemic.

“The pandemic restricted social contact, which is important in a child’s development. In addition, social media and screen time increased, resulting in more pressure from peers to post content online,” Kinnan said.

Kinnan, a member of the American Psychiatric Association’s (APA) Integrated Care Committee, says improving access to mental health care begins with a collaborative approach.

“The integration of behavioral health and general medical services improves patient health outcomes, decreases health care costs and reduces mental health stigma,” she said. “Significant research over three decades, conducted by the APA, the Academy of Psychosomatic Medicine and other health organizations, shows the Collaborative Care Model being effective and efficient in providing integrated care, particularly among patients who haven’t met their goals.”

The typical Collaborative Care team is led by a primary care provider and includes behavioral health care managers, psychiatrists and other mental health professionals. The team implements a measurement-guided care plan based on the following care models:

  • Patient-centered team care in which primary care and behavioral health providers collaborate effectively using shared care plans that incorporate patient goals.
  • Population-based care allows the care team to share a defined group of patients tracked in a registry, so no one falls through the cracks.
  • Measurement-based treatment targets each patient's treatment plan clearly, articulates personal goals and clinical outcomes that are routinely measured by evidence-based tools.
  • Evidence-based care offers effective treatments backed by credible research evidence.
  • Accountable care ensures providers are accountable and reimbursed for quality of care and clinical outcomes, not just the volume of care provided.

In Nebraska, medical and treatment information isn’t easily accessible or shareable among care teams. A patient may seek a specialist outside of their primary care provider network, which can lead to inaccurate medical information such as conflicting care or medications. The Collaborative Care Model allows for better flow of information between providers through shared medical records and patient-centered team care plans that incorporate patient goals. It reduces duplicate assessments, increases patient comfortability and engagement while resulting in a better health care experience, which aligns with Creighton’s commitment to cura personalis, care of the body, mind and spirit. Kinnan has been teaching the Collaborative Care Model to the Psychiatry residents at Creighton, and many plan to use the model in their future practice. The psychiatry program at Creighton has increased in popularity because medical students have more face-to-face interaction with patients as they are learning about their symptoms rather than running lab tests. They have enjoyed the collaboration with therapists and primary care providers that the Collaborative Care Model offers. Resident physicians in the program complete four years of medical school, in addition to a residency program.