Mildred Casiano, Union Community Health Center

Mildred Casiano is the Site Director of Behavioral Health at Union Community Health Center. Union provides comprehensive, quality healthcare services in a patient-friendly environment and plays an integral role in many of BPHC’s governance and clinical projects, including BPHC’s project aimed at integrating behavioral health into primary care.

Far too many Bronx residents say they experience serious psychological distress, yet far too few actually seek help. “Many people don’t want to be labeled ‘mentally ill,’” explains Mildred Casiano,Site Director of Behavioral Health at Union Community Health Center.

Fortunately, people struggling with depression or anxiety can now find mental health support at Union through their primary care provider. “Patients can come to Union to receive primary care, and the provider can easily conduct a ‘warm handoff’ with a behavioral health clinician,” says Ms. Casiano. “This decreases the stigma of receiving behavioral health services.”

Every primary care visit includes an evidence-based depression screening. When patients show symptoms of depression or anxiety, the provider conducts a “warm handoff” and walks the patient directly to the behavioral health clinician’s office, which makes patients far more likely to follow through with treatment. “The warm handoff is key to patients returning to behavioral health,” says Ms. Casiano.

Throughout treatment for depression or anxiety, Union’s primary care, behavioral health clinicians, and consulting psychiatrist work closely together to share patient information, monitor progress during every visit, and manage medication.

When Ms. Casiano began leading Union’s behavioral health integration in 2013, she knew that it would only be possible with the whole Union team on board. “The key was getting buy-in from doctors and nurses – they are integral in this whole process,” she says.

“What was essential in the integration process was training, education and phone consultation with primary care, which we’re still doing today,” Ms. Casiano says. “Providers are adapting to the idea that they have a behavioral health clinician they can rely on.”

Since the adoption of an integrated model of care, more Union patients are receiving the behavioral health treatment they need. “There’s been a big increase in referrals throughout our department,” says Ms. Casiano. She is heartened by these successes, but not surprised.

“Physical and mental health – there’s a link between the two. You cannot treat one without the other,” she continues. “That’s why this works. We benefit from each other’s expertise. You have to work as a team to improve outcomes.”

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(Published January 5, 2016)