Premier Consultations For Mental Health Care

Premier mental health care centers are committed to holistic and person-centered treatment. They also embrace innovative approaches such as telehealth to enhance access to care.

This synthesis of qualitative research explores mental health patients’ acceptability of video consultations, particularly from their perspective. A five-factor model is proposed to guide clinicians’ decisions on when to offer these services to their patients.

Behavioral Health Consultations

Behavioral health consultations are a short-term, goal-oriented approach to treating mental and emotional health challenges. Unlike counseling, which is more long-term and comprehensive in nature, BHCs work in conjunction with medical professionals to offer patients immediate resources. Typically, the first meeting with a BHC is covered under the $10 primary care visit charge. Behavioral health consultations are an effective treatment option for individuals struggling with Mood Disorders (such as Depression, Bipolar Disorder, Resistant Depression with Nasal Spray-Spravato), Anxiety disorders, and Addiction issues. Currently accepting new patients for Tele/Onsite Behavioral Health Consultations.

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Psychiatric Consultations

Our psychiatric services are provided by medical doctors (MD or DO) who treat mental and emotional disorders, including anxiety, depression, bipolar disorder, psychosis and substance abuse. We provide psychiatric consultations through face-to-face clinical patient interviews, case consultation through conversation and/or chart reviews. Psychiatric consultations are different from traditional outpatient psychiatric care as they do not result in ongoing treatment or management. Consultation can generate diagnostic clarification, targeted medication algorithms complete with dosing and necessary laboratory/medical monitoring, general psychotropic education covering the most common side effects, and referral recommendations for behavioral/community resources. However, the primary care clinician maintains prescriptive authority for all medications prescribed within the consultation.

In addition, the consulting psychiatrist has electronic access to the full medical picture for each patient, which can be difficult to obtain in a traditional outpatient psychiatric practice due to physical lags in receiving medical records, faxing information and/or phone calls, obtaining proper releases and mail time. This allows the psychiatrist to prioritize psychiatric medications that are compatible with active medical conditions and avoid overlapping prescriptions of psychotropic drugs.

Residents completing this training experience develop the ability to function as members of a multidisciplinary team in an integrated setting, assess and diagnose psychiatric issues common in FQHC settings, provide detailed recommendations regarding pharmacological interventions and communicate clearly and effectively with primary care providers. They also gain an understanding of the context of FQHC patients, limited patient resources and a population-based care focus.

Substance Abuse Consultations

Over the course of the consultation process, Ontario heard from many individuals and organizations that the provincial system needs to address wait times and barriers to accessing mental health and addictions services. Several of these concerns focused on the need to strengthen and expand community-based mental health and addictions supports and to align these services more closely with primary care and acute care delivery partners. One such initiative is the establishment of a Substance Abuse Consultation Team in a tertiary-care teaching hospital to provide expert diagnosis, assessment, and intervention with patients hospitalized for alcohol and drug abuse. The results suggest that this type of team could be useful to general hospitals in identifying, evaluating, and intervening with hospitalized patients who have substance abuse problems.

Emotional Health Consultations

Emotional health is a crucial part of one’s overall well-being. Mental health consultations offer a space for a collaborative exploration of a person’s emotional and mental landscape, equipping them with the knowledge they need to navigate challenges and cultivate wellbeing. Mental health consults can be of value at any juncture of the mental health journey. They can be used to help identify issues that may become more severe over time, or they can be a useful tool for monitoring existing issues and tracking progress as a person moves through their treatment.

Consultation liaison involves an interface between a mental health specialist and primary care providers (Berardi 2002; Bower 2005). The mental health specialist typically assesses the consumer with a mental health disorder, provides consultation to the primary care provider, and may also directly treat or refer consumers. The mental health specialist is not necessarily a psychiatrist; they may be a psychologist, social worker or nurse (Hedrick 2003).

There is some evidence that consultation liaison improves consumer outcomes, satisfaction with care and adherence to treatment, and the ability of primary care providers to provide appropriate psychological or pharmacological care. However, the quality of trials is low and the differences found between consultation liaison and standard care are small. Only two trials (Berti Ceroni 2002; Dobscha 2006; Katon 1999) and one trial (Worrall 1999) reported on symptom outcomes at three and 12 months, but there was high heterogeneity in the analyses.