Olga Victor is a Behavioral Health Clinician 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.
“I have one particular patient who is diabetic, had open heart surgery several years ago, and he has a long history of depression,” says Olga Victor, a social worker and Behavioral Health Clinician at Union Community Health Center. “He had never been in therapy consistently – at one point he was smoking marijuana to medicate.”
From time to time, however, he did see his primary care physician at Union. During one visit he underwent an evidence-based depression screening called a PHQ9. His score was dangerously high, and his doctor walked him to Ms. Victor’s office. “There was face-to-face contact, which we call ‘a warm hand off,’” Ms. Victor explains. “It helps patients become comfortable with the transition from primary care to behavioral health.”
In that meeting, he scheduled the first appointment with Ms. Victor and, after completing the initial psychosocial assessment, he scheduled a psychiatric evaluation to assess his medication needs. “It took a long time – he’s been with me now for 9 months – to get him to be consistent with all his treatment,” she says. In fact, it took the collaboration of the entire team – Ms. Victor, his primary care doctor, his psychiatrist, and his patient navigator – to help him make his appointments, manage his medication, and ultimately get better.
This vigilance and support has paid off. Today, Ms. Victor says, “his PHQ9 has changed drastically, down from 25 to 12. He’s lost over 35 pounds, and his overall health has tremendously improved.”
For most of Ms. Victor’s 25 years of working in behavioral health, stories like this were few and far between. “The integration with primary care was never there,” she remembers. That was until she arrived at Union, which integrated its primary care and behavioral health departments in 2014.
Today, the PHQ9 screening is standard practice in Union’s primary care visits, the warm handoff is a central source of behavioral health referrals, and the cross-departmental communication is second nature for Union staff. “Here, you take care of the physical health and the mental health all in one place,” Ms. Victor says. “It’s a holistic way of treating the patient.”
(Published April 7, 2016)