Mental Health Integration in a Women's Health Clinic: Real World Implementation

Background: There is a critical shortage of mental health (MH) services which is projected to increase. Mental Health Integration (MHI) is one approach to increasing access to MH services. MHI is also shown to increase provider satisfaction and improve patient outcomes. In many settings where resources are already low, full-time MHI may not be an available option. The purpose of this intervention was to improve Women's Health Provider (WHP) satisfaction with access to MH services for their patients by embedding a Psychiatric Nurse Practitioner (PMHNP) in the clinic for four hours a week. Method: This quality improvement project assessed WHPs' perceptions, attitudes and referral patterns before and after MHI. Surveys were used to assess WHPs' perceptions of how to best utilize an in-clinic PMHNP. Pre and post surveys were used to assess WHP attitudes towards MHI before and after embedding a PMHNP into the clinic. Business analytics and chart review were used to identify differences in referral patterns before and after implementation. Results: 13 WHPs participated. There was no difference in WHP perception of how the PMHNP should be used for MHI in the clinic. The was no difference in WHP satisfaction rates and referral practices before and after embedding a PMHNP in the WHP clinic for four hours per week. WHPs highlighted communication (n=4) , access (n=11), quality (n=4) and trust (n=3) as positive elements of MHI. Conclusion: Providers expressed appreciation for having dedicated, direct access to a MH provider and specifically highlighted the ease of communication and trust. However, four hours a week of MHI did not improve WHP satisfaction with MH access for theirpatients.