NCDHHS approves additional funding to implement behavioral health services

In October, the North Carolina Department of Health and Human Services announced an additional $5 million to expand access to behavioral health providers and managers into primary care offices.

The money will support capacity-building efforts, allowing primary care providers to implement a collaborative care model, which embeds behavioral health care within primary care settings.

The model includes integrating a behavioral health case manager and psychiatric consultant to work alongside primary care providers to treat mild to moderate behavioral health conditions.

Eric Christian, the director of Behavioral Health Integration at Community Care of North Carolina, said the model will allow patients to receive consultation from a psychiatrist and be prescribed medication at their primary care office that their provider would otherwise be unable to issue.

"We've got to make sure that we're doing things in schools and in other places where people might be, but having this in as many different primary care settings as possible, is what our goal is — to be able to screen for and do prevention work so that people don't progress in the level of severity of symptoms and disability associated with a behavioral health condition," Dr. Keith McCoy, associate medical director for mental health at N.C. Medicaid, said. 

Primary care providers who have adopted this model can apply for up to $50,000 in grants to help implement it into their main offices. The funding applications opened on Oct. 10 and eligible primary care providers can apply for individual grants for each site.

Priority will be given to providers in rural or high-need areas, particularly in western North Carolina locations impacted by Hurricane Helene.

Dr. Brittany Watson, associate medical director consultant for N.C. Medicaid, said the behavioral health care managers cover a space she cannot as a family physician.

“If there are significant mental health barriers that are taking place, they go hand in hand [with physical health problems], and the behavioral health care manager has specific skills and the time to really dive into some of those issues as opposed to the primary care provider,” Watson said.

Funding expansions and reducing stigma around behavioral health care is an aspect the NCDHHS has been focusing on with recent investments, McCoy said.

The funding is a fragment of a wider movement to increase access and efficacy of behavioral health programs promoted by the Collaborative Care Consortium, an organization of leaders and representatives from primary care and psychiatric providers.

Many patients drive hours to see a specialist and face transportation barriers while attempting to access behavioral health care, Christian said.

Christian said the funding is especially important for incorporating behavioral treatment into primary care offices in rural areas because they already lack specialized services.

“[The] model allows for people to access screening and assessment and evidence-based interventions and treatments in that primary care setting — a place that hopefully they're already comfortable," McCoy said. "It means that they don't necessarily have to go make an appointment with a new therapist or a new psychiatrist who they don't know."

Another aspect of the broader program includes training efforts for staff and general practices in the field of behavioral health, which he said can count for providers' licensures who hope to expand into behavioral health. Education for behavioral health integration will be provided by local area health education centers.

"This particular model helps create a team to support the patient and allows the patient to get the care they need with the primary care providers still being heavily involved," Watson said. "All being taken care of under one roof."

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