Interview with Mogens Bill Baerentzen, PhD, CRC, LMHP
Project Coordinator, Mid-America Mental Health Technology Transfer Center
The last couple of years HealthTeamWorks has collaborated with the Mid-America Mental Health Technology Transfer Center (MHTTC) to support behavioral health integration in primary care in Nebraska. We interviewed Mogens Bill Baerentzen, PhD, CRC, LMHP from Mid-America MHTTC to get his insights on the changing landscape and how this has affected behavioral health integration.
Tell us a little bit about yourself and what Mid-America Mental Health Technology Transfer Center (MHTTC) does.
My name is Mogens Bill Baerentzen and I am a project coordinator of Mid-America Mental Health Technology Transfer Center. I have a BSN from a university hospital in Copenhagen Denmark, a Master degree in Rehabilitation Counseling and PhD in Psychology from Illinois Institute of Technology. Our center works to increase utilization of evidence-based mental health practices in Department of Health and Human Services (HHS) region 7 of Nebraska, Iowa, Kansas and Missouri. I lead our efforts to improve services for persons with serious mental illness.
What are your thoughts on the increasing need for mental health support?
Persons with serious mental illness live significantly shorter lives than persons without. Studies suggest that this difference in life expectancy is 20-25 years. This health disparity is primarily attributed to modifiable risk behaviors, and related higher rates of chronic illnesses such as diabetes, hypertension, lipid disorders, lung disease, infectious disease, and alcohol and drug use disorders. Our mental health and physical health are related, and many suggest that a holistic approach to healthcare is both effective and efficient.
What do you see are the challenges in integrating behavioral health in primary care?
- In rural areas of our states, we find significant behavioral health workforce shortages making access to care difficult or impossible. Persons with a mental health concern or disorder often have to drive hours for mental health appointments and lack internet access for telehealth care. Several ideas are proposed to address these issues, including integrating behavioral healthcare into primary care settings.
- Because of the lack of integrated training sites and siloed primary and behavioral health workforce training programs graduates are not prepared to collaborate in primary care settings. This creates a demand for practices to train both existing and new staff.
- Successfully integrating behavioral health into a primary care setting, while seemingly simple, require changes to both clinical and administrative practices. Small practices need a deliberate and context specific plan to implement and sustain integrated care.
- Evidence-based practices of integrated care place a high premium on a shared workspace for the primary care and behavioral health practitioners. In programs with limited space, where the two workforces have limited interaction, we find that sharing of information and collaborative care suffer.
How is Mid-America Mental Health Technology Transfer Center positioning itself to best support practices in behavioral health integration?
- We are a Substance Abuse and Mental Health Services Administration (SAMHSA) funded program and part of a nationwide network that has significant experience in a wide range of areas. Our center has made integrated primary and behavioral healthcare our top priority. We are located at the Munroe-Meyer Institute at the University of Nebraska Medical Center and have strong ties to the Behavioral Health Education Center of Nebraska. Our faculty are national leaders with decades of experience working in integrated care settings and a strong record of accomplishment of providing training and technical assistance on these issues.
- Angie Schindler-Berg, Project Lead at HealthTeamWorks Nebraska is a strong advocate for integrated care. We have learned a lot from her and the practices she supports across the state. We have presented at bi-annual learning sessions, assisted rural primary care practices with recruitment of competent behavioral health professionals, facilitated several webinars, and provided direct consultation to several practices.
What are the behavioral health support activities practices can implement in a short term?
- The first thing we can do is to understand the behavioral health needs of our patients. It is simple for all practices to assess and screen for mental health needs. There are simple, valid and reliable tools to identify patients with disorders such as depression, anxiety and substance use.
- Similarly, all practices can establish comfort in talking to patients about their mental health. While this comes natural for many professionals in a primary care setting, others might find it difficult to talk openly to patients about substance use, depressive moods, anxiety, and psychotic symptoms. However, with practice, training and some coaching from others most professionals gradually learn to approach these topics with sensitivity and respect.
- Persons with more serious symptoms, where the mental illness has disabling effects, a primary care clinic might need to refer out for care that is more specialized. We have programs in all areas of our states to support persons with serious mental illness to live independent, be successful at work and have meaningful and healthy social networks. Practices can contact regional mental health authorities to inquire about such services and how to best collaborate to maximize care, and health and social outcomes.
How should practices plan for future?
- First, take a deep breath and visualize your clinic being able to care for all the patients that struggle with their mental health in silence. Imagine a day, when you have a qualified professional in the practice to help your patient who have suicidal ideations, who you suspect have a troubling relationship with drugs and alcohol, or who you know have a long history of depression and need to talk to someone.
- Practices can benefit from talking to other practices who have succeeded with integration. There is a lot to learn from others’ experiences. What worked? What didn’t? Where did you find help? Where did you start? How long did it take to be finically viable? Etc.
- Identify training and technical assistance resources like those offered by Mid-America MHTTC. Understand that you can drive this process and gradually move towards a successful implementation. Take your time and develop a plan to address funding issues, training needs, space issues, technology needs and workflow.
For more information about Mid-America Mental Health Technology Transfer Center, please go to https://mhttcnetwork.org/centers/mid-america-mhttc/home
Interviewed by Angela Schindler-Berg, Project Lead at HealthTeamWorks Nebraska