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Currently researching this for my thesis! Thank you for a clear picture of the role 🙏🏽

Instead of the BHC trying to read all of your nonverbal cues, how about the providers clearly state verbally what their preference is? that would eliminate all the confusion of BHC trying to guess what you might be asking for or not.

'Promo SM' 🙃

great explanation and the easiest way put it together to be understood thanks doctor

I had to Google what a BHC stands for. :) Thank you for the video!

Fantastic! Thank you!

Thank you, Dr. Serrano! Your explanation of SOAP note is precise and direct. My professor, JP, at CSUEB referred me to watch your video.

I needed this today! I often feel like I'm battling to make my setting more PCBH, but I am the only BHC in my system and I serve two clinics. This means there are days in each clinic where they do not have a BHC on site, and it's been difficult to work on buy-in. Thank you for validating my PCBH-ish framework, while hopefully we will be able to increase our workforce and move to a more PCBH model soon.

Spot on. Most of the time IMO...folks are struggling with the 1st scenario you went through...where the health system doesn't have what the person needs...the clinician panics and erroneously concludes they need specialty care! Thank you for taking on this topic!!!!

🙏 "promo sm"

As far as text goes, I'm copying it in here as best as I can from a formatting perspective. Hope this helps - it is built for EPIC. ASSESSMENT: PT with (1***), related to (2***), in the context of (3***). Patient would benefit from (4***). Stage of change: {Stage of change: 5 xxxxx} Intervention Type: {BHCintervention: 6} Diagnosis: {Current visit dx: 7 xxxxxx} PLAN: 1. F/U with behavioral health consultant {Time Interval: 8}. 2. Medications: {Medication: 9}. 3. Behavioral recommendation(s): A. 10 *** B. *** SUBJECTIVE: Pt here for {11 INITIAL CONSULTATION/ REFERRAL/ FOLLOW-UP/ OTHER:} regarding 12 ***. {13 Gender/Parent:} reported the following symptoms/concerns: 14 *** Progress towards prior plan: {15 BHCprogress:} Duration of problem: {16 BLANK:19884::"1-2 Weeks","2-4 Weeks","1-3 Months","3-6 Months","6-12 Months","Several Years","Lifelong Course","Lifelong Course With Waxing & Waning","Lifelong Course With Recent Exacerbation"} Severity: {17 BHCSeverity:} OBJECTIVE: Referred by: {18 BHCpcp:}. Orientation & Cognition: Oriented x3. Associations logical, no gross signs of thought disorder. Mood, Affect: {19 bhcmood:}. Appearance: Appropriately dressed and groomed. Harm to self or others: {20 BHCHarm:} Substance use: {21 BHCSubstanceuse:} Psychiatric medication use: {22 BHCmeds:} Health risk behaviors: {23 BHChealthriskfactors:} Completion of screening measures: 24 Yes/ No; {25 Screening Measures:} -------------------------------------------- Time spent face-to-face with patient: 25 *** minutes -------------------------------------------- @ME@ {BLANK:19884::"The patient was informed of the following characteristics of their care within the primary care medical home at XXX Community Health Centers: a. Behavorial health providers operate as consultants to the medical team and not as stand-alone providers of care, b. All information discussed with team members as applicable/appropriate will be documented in the shared electronic health record and visible by all care team members, c. The Behavioral Health Team works as a group providing care to all Access patients and as such a patient is likely to work with multiple Behavioral Health providers. Patient consented to meet with BHC."} ------------------------ *Note that the elements in {brackets} would be drop down or list elements in EPIC that are unique to your build. In other words, you can't copy this into EPIC and have the lists work, but you can easily replace the lists with similar lists in your iteration of EPIC

thank you for this! Is your progress note template available for universal use?

Love your videos, I am working as a BHC ,the concept is not new to me but I had to have a better understanding of how to proceed and your video have been helpful.

Thank you for this breakdown

#PAIN contracts are not #contracts at all! They are 3 pages of 37 itemized reasons for so-called PAIN doctors to DISCHARGE patients in agony!

638

Thanks. I learned a lot from this video!

SOWK 638

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This role wears a hat of crisis intervention specialist The hat of a broker. The hat of an advocate. The hat of a motivational interviewer. The hat of problem solver.

If a patient knows they will be in a lot of pain if their doctor discontinues their pain med for not improving in function, they are likely to lie about their activities.

Is there a template of this available

This was excellent! Thank you.

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😍😍😍😍😍😍

Dr. Serrano, your videos are incredibly helpful! Thank you. Is it possible for you to provide a transcript of each of your videos? Some You Tube creators enable that option below their videos. I found your introduction to IBH to be useful and would love to read along as I listen to it again. Thank you for your time, knowledge and dedication to providing quality information and service.

Thank you this was very helpful, however i think that you should also physically write out a few SOAP notes to give to the viewer an idea of what it looks like

Thank you.

no volume

@NEFTALI SERRANO, PSYD. Why don’t you just say in the video you’re title )? “DR”may be technically correct, but it’s misleading and silly

I

Thanks a lot very helpful

This is so helpful! Thank you! I am new to the role and in orientation period trying to figure out scheduling etc.

Jayden

Thank you, that was helpful!

HI. Do you have an email where I can reach you? I am a LCSW with Veterans Affairs and would like to ask a few questions. Also, to get your approval to share your videos. Thanks!

Excellent overview of the three models

This was very helpful to me. Thank you so much. I also have to say that the Leg Lamp in the background was the perfect addition. LOL!

Do you have any recommendations for using ACT in BHCs?

thank you! very helpful in understanding the vocab associated with integrated care models

hi dr. serrano! i just wanted to say thank you so much for your videos. i am a counseling student that is interested in working in an integrated care model in the future and have been watching your videos to get more information!! a question i have for you is, for me who is just a student in mental health counseling (going to graduate with an m.a), what steps should i take and what should i study in order to hopefully end up in a clinic and prepare myself as best possible. thank you!

Dr Serrano, your podcast have been helpful. I appreciate your willingness to share your knowledge and experience.

Basically decentralized V. centralized management, inclusive V. exclusive care team and improving quality of life V. improving level of care appearance.

How much time, if any, do you spend on the phone with patients, doing case management-like activity? (i.e. referring a patient to a community-based mental health specialty practice when their treatment needs are greater than what a BHC could provide in a 20-30 minute encounters.) And, if you do spend time on the phone, how is that time recognized by your agency? Our productivity is measured by # of face-to-face encounters, %of encounters that fill out the PHQ-9. Our PCP's will often request that we contact one of their patients to help them get connected with a psychiatrist and/or therapist in the community, so I contact the patient and help them negotiate the complicated system of getting connected with a provider who can address their treatment needs. And, do you get directly involved in filling out patient's FMLA forms and short term disability forms. If we have seen patient a few times, and the patient is out of work due to a mental health condition, our PCP's will ask us to fill out these forms.

Hi Dr. Serrano: I just want to let you know that I enjoy and value your podcast entries. I have been embedded in a large primary care practice for 2 years. At the time that I started, there was not a clear definition of what my role would look like there. So I have utilized your guidance to help me find my way in the practice. And, now I have 12 fellow BHC's in other primary care satellite offices doing what I do. So, I emailed them links to your youtube podcasts, and we recently had discussions about our work, utilizing your work as a springboard. So, thank you!

Great description of how Behavioral Health Consultants can assist PCP in saving time and providing a broader spectrum of care.

Thank you, doctor. I'll be using this in my work.

Excellent!

Thanks for sharing. Documentation and Epic are continued struggles for our providers. Do you do any diagnostics assessments or health and behavior assessments in primary care? (In Minnesota we are required to even though it's primary care. ) If so, what does that look like? Any tips or tricks for making that more efficient for your PCBH providers?