Framework for Enhancing Health Service Provision in Rural Settings

Integrated Behavioral Health in Rural Communities Integrated behavioral health involves working with a primary care physician, a medical specialist and a team of people to bring the best care possible for a patient. This is important when viewed from various dimensions. For instance, a client in need of special care for a condition or a disease might need a team of healthcare professionals to ensure essential tasks are completed.

Therefore, integrating primary care will help patients in rural communities manage their health because they learn to adapt new solutions into their everyday lives. Besides individuals being integrated, healthcare facilities and clinics work together to coordinate care for people in need (Chaple, 2015). Framework for integrated behavioral health in rural communities Regardless of the advancements and positive changes in the support, treatment, and understanding of mental illnesses in the rural communities, the need for improvement in the rural healthcare system cannot be downplayed.

Researchers acknowledge that even though advances have been achieved in the rural behavioral healthcare, most mental health victims are still disadvantaged and not receiving proper care. In most cases, mental health disorders are as disabling just like heart disease or cancer as far as premature death and lost productivity are concerned. A study conducted in 2006 document that people with the most critical mental illnesses would die 30 years earlier than the average American citizen.

If left untended to, mental disorders adults tend to experience unsuccessful relationships, lost productivity stress and a negative effect on raising a child. A comprehensive care structure must promote mental health integration that treats patients at the point of care where patients are most comfortable and uses a patient-oriented strategy to intervention. In addition, integration is crucial for positively affecting differences in health care in rural populations (Acevedo-Garcia et al., (2012).

Medical-provided behavioral healthcare model Medical-provided behavioral healthcare is a delivery framework whereby only the medical providers are directly engaged in the service provision. For instance, the physicians can do simple things to deal with behavioral health problems. This may include supporting patients to use a daily diary to plan some activities, discussing an exercise schedule with depressed patients or even having a nurse to follow up on a patient through a telephone call to guarantee medical compliance (Bao, Casalino, & Pincus, 2013). Under this framework, consultation-liaison is often used.

Here, the primary caregiver delivers the behavioral health care service while a psychiatrist gives consultative support. The aim is to improve the ability of the primary healthcare provider in treating patients with behavioral health problems within a primary care setting. As the sole primary care consultant, the psychiatrist delivers care by seeing patients with the physician or advising through the telephone but s/he does not co-manage the client (Chaple, 2015). When primary care providers are diagnosing a behavioral health issue in patients, they use evidence-based behavioral screening devices.

An example of such tools is the "Patient Health Questionnaire" (PHQ-9), which is frequently used to identify people with depression. This questionnaire contains nine items that can be easily filled within two minutes. Equally, the physician affirms the symptomology of the depression. This is achieved by talking with other providers, talking with the patient or reviewing PHQ-9 scores. Then, s/he adopts brief algorithms for treatment. This practice is commonly known as screening and brief intervention (SBI).

In most medical facilities, screening of depression has been integrated as a routine practice in the care for people with chronic diseases. This procedure starts with a brief two-question screening, where the first two questions of the PHQ-9 are used. Besides, an increasing number of primary care homes are screening for a multitude of issues like substance abuse, panic disorder, and bipolar disease. For adolescents and children, most practices are using a "Pediatric Symptom Checklist" because it is the global behavioral health screening device (Gee & Payne-Sturges, 2004).

There are brief intervention guidelines, developed for various behavioral health problems observed in primary care. In most scenarios, the primary care physician could deliver brief interventions directly. The American Academy of Family Physicians (AAFP) devised various algorithms for some disorders. Moreover, the American Substance Abuse and Mental Health Services Administration (SAMHSA) are implementing Screening, Briefing Interventions, Referral and Treatment (SBIRT) programs.

It is argued that interventions would be effective in minimizing both the severity of mental health disorders, hospitalizations and the number of unnecessary emergency department visits (Bao, Casalino, & Pincus, 2013). Evidence base There is a substantial proof base for the success of SBI in treating substance abuse in primary care facilities. This includes treatment for other common issues like smoking, pain, generalized anxiety, panic disorder, and depression. However, primary caregivers are more expected to screen for depression other than substance abuse.

My career goals related to integrative behavioral health in rural communities As a Primary Care Behavioral Health Counselor, my primary career goal is to increase the percentage of eligible patients who receive proper behavioral and mental health services in rural communities.

To achieve this goal, I would assist primary caregivers in: Identifying and treating psychosocial problems and mental disorders Early detection of risk clients with the goal of deterring further physical or psychological deterioration Preventing morbidity or relapse in conditions likely to recur over time Preventing and managing addiction to tranquilizers or pain medicine Managing and preventing work and functional disability Effective and efficient management and treatment of patients with chronic emotional issues Achieving quality clinical results for high prevalence mental problems Enhancing the quality of primary caregiver treatments without the support of behavioral health consultation Successfully shifting clients into proper mental health specialty care as directed Skills and qualities that I will bring to the IBH field practicum setting Primary Care Behavioral Health professionals have the clinical skills and credentials to pursue a working role in the IBH field practicum setting.

Among these roles include offering consultation with multidisciplinary teams, teaching interpersonal skills to medical providers and working in consultation with patients in behavior change to minimize their health risk factors. The IBH arena needs mental health professionals like a counseling psychologist to form active members of research and treatment teams to meet the multidimensional and complex needs of patients (Gee & Payne-Sturges, 2004). As a clinical professional counselor, I value the collaboration procedure between integrative health care.

Through the course of my training, I have acquired a core set of behavioral intervention skills and knowledge in the following areas: Powerful skills base.