WSUPG and Wayne State leading the way in behavioral health care
November 10, 2019
The Wayne State University Physician Group, together with the Wayne State University Psychiatry department, are national trendsetters in the care of patients with behavioral health issues.
Innovative models of care developed by WSUPG and Wayne State Psychiatry have increased access to mental health care, improved outcomes, reduced cost and are being adopted by other health providers across the country.
All this comes at a time when behavioral health demands are growing, with patients needing mental health care flooding emergency rooms, prompted by socio-economic stress and a shortage of inpatient psych beds.
Detroit is ahead of the curve in addressing these needs.
David Rosenberg, M.D., chair of the department of Psychiatry and Behavioral Neurosciences at Wayne State’s School of Medicine, said an emergency room diversion program is reducing emergency room stays and visits for behavioral health patients at a savings for Michigan taxpayers.
“Our new models of care for the most vulnerable and high-risk populations in Detroit have demonstrated a 94% reduction in repeat ER visits and inpatient psychiatric hospitalizations. In one year, that saved Michigan’s Medicaid program $7.5 million.”
Under the emergency room diversion program, psychiatric social workers and psychiatrists team up with ER physicians to do psycho-social assessments and start psychiatric treatment, rather than simply holding a patient in the ER for admission to a psychiatric facility.
“Many behavioral health patients come back to the ER multiple times,” explained Dr. Rosenberg. “For example, one woman in our program, who had bipolar disorder, came in hundreds of times a year, and this had been going on for years. Most of her hospitalizations were occurring in summer. Through a psycho-social assessment, we learned she had no air conditioning in her apartment. By addressing this underlying problem, she’s now down to 3 or 4 ER visits a year.”
Although the primary location for the ER diversion program is Detroit Receiving Hospital, Dr. Rosenberg and the WSU Psych team have worked with health systems and hospitals across the Detroit Metro area and the state to spread these best practices.
Telepsychiatry programs in group homes and federally qualified health centers have also significantly reduced ER visits and reduced costs by nearly $16 million.
“We are using laptops, cell phones and personal computers to work with patients in their homes. We’re also doing a twist on telemedicine called hybrid telemedicine where we train mid-level providers, such as psych social workers and nurse practitioners, to use technology in assessing and treating patients at an internal medicine clinic in Detroit,” said Dr. Rosenberg.
But the real gamechanger in behavioral health lies in integrating mental health care with physical health care in primary care settings for vulnerable, high-risk populations. That’s the goal behind a new multidisciplinary clinic that’s being planned for WSUPG’s new location at 400 Mack Ave. in Midtown.
“It’s not reasonable to separate all things above and below the neck,” said Dr. Rosenberg. “It just makes sense that if a person is stressed out, it leads to heart and other medical issues. Successful people are in harmony in terms of mind-body interaction.”
Through an integrated care clinic at 400 Mack, psychiatry professionals will work hand-in-hand with medical professionals to address patients’ mental health and physical health needs.
“Medical colleagues are now embracing an integrated approach because most repeat-visit patients are those with a behavioral psych or substance abuse problem that, so often, goes undiagnosed or unrecognized. If you have emotional problems, it’s harder to take care of yourself. All these things come together,” said Dr. Rosenberg.
“Rather than treating someone over and over and getting the same result, we are changing our approach. With integrated care, we can decrease cost, reduce medical and psychiatric hospitalizations and make the lives of patients and families better by taking care of the whole person.”
WSUPG expects its integrated care program at 400 Mack to open in 2020.