Here and now: Reducing barriers to behavioral health integration

Community clinics across the U.S. are being encouraged to integrate mental health and substance use disorder (SUD) services with primary care. Screening patients experiencing homelessness in primary care clinics for behavioral health problems can be uniquely challenging, and connecting them to the help they need even more so. This presentation will highlight lessons learned and adaptations implemented during the process of building a successful SAMHSA level-six integrated practice at a primary care clinic for persons experiencing homelessness in Salt Lake City, Utah. Some of the central themes of a successfully integrated clinic serving people without homes include timing, flexibility, and creativity. Traditional systems for screening and referral of behavioral health conditions are designed with a certain population in mind: patients with cell phones, calendars, and frequently checked email. Integration of behavioral health in homeless health care requires providers of care to acknowledge that critical interventions need to be delivered on the timeline of the patient, which usually means now. Providing timely behavioral health care for persons experiencing homelessness requires a high degree of flexibility from both clinicians and program administrators, but it is possible and compatible with the highest standards of care. Holding a master’s degree in psychiatric advanced-practice nursing from the University of Utah and a doctorate degree in nursing, the presenter has researched, designed and implemented a fully integrated behavioral health program at the Fourth Street Clinic, providing mental health and substance abuse services to people experiencing homelessness in Salt Lake City.