Kaiser Permanente Northern California is expanding access to mental health care by embedding therapists in primary and specialty care. Pictured, Sarah De La Cerda, LCSW.
A Kaiser Permanente member arrived at his doctor’s appointment feeling shaky and vaguely off-kilter.
Not seeing a physical injury or illness, his Kaiser Permanente South Sacramento physician consulted with 1 of 18 mental health therapists embedded in the area’s primary care offices, including adult medicine, pediatrics, and gynecology, and specialty services, such as oncology.
“A therapist went into the exam room and found not only was the patient severely depressed, anxious, and abusing substances, but all of that was going to result in him losing custody of his children,” said Hillary Van Horn-Gatlin, PhD, Behavioral Medicine chair of chiefs for Kaiser Permanente Northern California. “He was able to talk to someone on the phone that day and get connected to mental health services. Following treatment, the therapist heard from the patient, who was clean and sober.”
Mental Health Care Integrated within Kaiser Permanente
The story illustrates how Kaiser Permanente makes it possible for members to receive mental health care throughout the organization in a variety of touch points, even if they arrive at their doctor’s office not knowing at the outset that they need it.
The integration of mental health professionals in primary care offices expands opportunities for assessment and diagnosis and is changing the way patients perceive the concept of getting help for mental health issues.
“We’re destigmatizing mental health by being in primary care and being in the general exam room,” Van Horn-Gatlin said. “A lot of patients don’t realize their physical complaints can be a part of a psychiatric condition. So, this is about taking care of the entire patient.”
Sarah De La Cerda, LCSW, a mental health therapist embedded in the Adult and Family Medicine Clinic at Kaiser Permanente Oakland, said by being available to patients in a primary care setting, she can provide preventive care before mental health issues reach crisis proportions.
“I think we’re really helping to redefine what mental health care looks like,” De La Cerda said. “We’re saying, ‘Let’s not wait until this gets really bad.’ Or if members are in crisis, we can get them a full psychiatric evaluation, and we can help bring them into the system to get more intensive care.”
Not only is Kaiser Permanente offering mental health care access in new venues, it is re-imagining care delivery, so patients are more likely to feel engaged in solving their problems.
“It doesn’t mean we have to sit down for an hour and look at everything,” De La Cerda said. “That can be challenging and intimidating for people.”
In fact, help may come in many different forms. That could be a 10-minute conversation in the doctor’s office about stress with a follow-up, it could be a phone call, or maybe a 30- to 40-minute in-person visit with a therapist, De La Cerda added.
Daniel Dal Corso, PsyD, manager of behavioral medicine specialists in San Leandro, Fremont, and Union City, said having more therapists in more settings outside of traditional psychiatry offices means Kaiser Permanente is reaching more people in need.
“This is a way of getting closer to where a large number of people present their problems and a way of intervening more quickly,” Dal Corso said, adding that this approach contributes to Kaiser Permanente’s leadership in the field of mental health.