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Banner imbeds mental health experts at clinics

Tribune - 1/24/2024

Jan. 23—During the pandemic, appreciation for the importance of mental health reached new highs.

But despite wide recognition of the benefits of mental health care and calls to expand availability, hurdles remain in accessing therapy.

Banner Health group is aiming to lower the barriers to mental health care with a new initiative that launched last year and expanded in Mesa this month.

Through a partnership with Phoenix-based evolvedMD, Banner is embedding licensed mental health therapists in some of its primary care clinics.

The goal is to create a seamless transition between physical and mental health services.

On Jan. 12, Banner Health officially welcomed two evolvedMD clinicians to its Mesa clinic at Country Club Drive and Southern Avenue — the second Banner clinic in Mesa to embed mental health professionals.

Dr. David Valenzuela, a family medicine physician with Banner, said the new initiative will make it easier for patients and doctors to incorporate mental health into their overall health plan.

"Pretty much all physicians understand the profound impact that serious mental illness disorders have on physical health," he said.

In the past, though, billing complications, a shortage of providers and lingering stigma over mental disorders contributed to mental health concerns going untreated — ultimately eroding physical health.

"We've traditionally been in our society asked to 'suck it up' or, 'rub some dirt on it,' so to speak, and as a society, we discourage folks from access to care or talking about mental health issues," he said.

"There is a myriad of evidence that, whether it's diabetes, high blood pressure, obesity, you name it, having a positive outlook, or managing depression and anxiety improves outcomes in those illnesses," Valenzuela said.

At the Country Club clinic and other locations where the medical group is partnering with evolvedMD, licensed therapists will be "at the elbow" of the primary care physicians.

Valenzuela said this means mental health professionals are available for a quick consult to answer a question or may even provide immediate service to a patient through a "soft handoff" between physician and therapist.

The therapists with evolvedMD have their own office space in the Banner clinics, and patients can book appointments with evolvedMD providers at the clinic separate from a doctor's visit.

Sentari Minor, vice president of strategy for evolvedMD, said the company complements the onsite therapists with a network of care coordinators and specialists.

Therapists with evolvedMD can consult with a psychiatric nurse practitioner if they determine that medication might be a beneficial treatment disorder.

The psychiatric nurse issues a recommendation for the primary care doctor, who is the prescribing physician and manages the medication for the patient.

Debbie Barnwell, a licensed behavioral health manager at the Mesa clinic, said she has seen patients fearful or hesitant to see a counselor overcome those barriers because of the embedded model.

"Because let's face it, (the patients have) had the relationship with their primary care for years and have a lot of faith in that direction. It helps to nurture taking that step," Barnwell said.

Leslie Stumpff, clinical manager for evolvedMD, said it can also provide patients with a greater sense of privacy and reduces the need to discuss their mental health with others.

"I had several patients that because of the stigma, they would tell their family they were going to the doctor," Stumpff said.

"I even had an older lady that her son would drop her off — and he always thought she was just going to the doctor — but she was coming to see me for counseling."

"Occasionally, of course, she kept going to the doctor," Stumpff laughed.

Stumpff added that sometimes physical conditions trigger mental health symptoms, and therapists working side-by-side with doctors helps with "addressing the whole person and getting their needs met."

"Debbie can literally walk down the hall and talk to the primary care provider and have a conversation about the patient's condition and health," she said.

Barnwell said she likes providing mental health care through the embedded model.

"It is very nice to be part of a team," she said. "For too long, people were in different offices, different sides of town, and when you get a chance to have a team working together ... it is a lot better for the team, but most importantly, the patient."

Valenzuela said the partnership with evolvedMD also simplifies billing for Banner patients because the therapy is billed through their primary care doctor under their medical benefit.

"Some payers, some insurances may not have as robust of a behavioral health benefit, and the minute they leave that primary care setting" coverage may be shakier, he said.

"If your insurance covers me as the primary care provider, it will cover this as well," Valenzuela said of embedded counseling services.

Currently, evolvedMD is integrated into Banner Health Centers in Queen Creek, Mesa and Peoria with plans to expand to Banner Health Centers in the central and west valley in the coming months.

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