“I love my field,” shares Dr. Manuel Castro, medical director of Atrium Health’s Behavioral Health Integration program. “I think it’s the one field where you get to know the person completely, not just by an illness. I’m passionate about it.”

Depression, anxiety, and other mental health conditions can cause a lot of suffering for patients and their families. More than 450,000 adults and young adults in North Carolina have a serious mental illness, and an additional 500,000 adults and 141,000 young adults have a substance abuse disorder.

Because North Carolina faces shortages in behavioral health specialists, many people with mental health disorders go untreated, even while mental disorders are common and effective treatment exists.

Atrium Health’s Behavioral Health Integration program seeks to address these issues using virtual models and a team-based, primary care-integrated approach.

The program embeds a therapist or other behavioral health professional directly in primary care practices, supporting the ability of pediatricians and primary care doctors to screen for and treat serious and diagnosable mental health conditions.

If a visit with a consulting psychiatrist is needed, that visit can be conducted immediately through a video visit right in the primary care office.

After a short visit, the psychiatrist gives recommendations back to the primary care physician regarding medications, therapy, or other services like addiction treatment — whatever is needed to support the patient and improve their quality of life.

“The primary care physician and the patient are still the captains of treatment,” Castro says. “We call ourselves the navigators — we’re going to help you guide the ship safely, but we will guide you in the direction you want to go.”

This work is particularly important right now, as COVID-19 has exacerbated many mental health conditions.

“The suicide rate is up significantly in North Carolina and across the nation,” says Dr. Wayne Sparks, senior medical director of Atrium Health’s behavioral health services. “It’s not going to be getting better post-COVID, that’s just what we know happens after pandemics. We can do better, we can get that information to people, and actually screen them. It’s really important.”

COVID-19 also accelerated the adoption of virtual visits and telehealth services, which Atrium Health and other healthcare systems are leveraging to provide more and better care. However, continued support from stakeholders and state leaders will be key to continuing to expand integrated virtual care programs, Dr. Sparks said.

“If we can keep getting that support, keep getting payers that are going to pay, and see that we’re making a difference and getting the patient what they need, and paying for it like it’s a regular in-person visit…we’re going to see more and more improvement.”

Using a team-based and virtual approach, Atrium has been able to make up to 900 behavioral health referrals a year and manage more than 600 patients, Castro says.

“When I look at why I started and why I’m passionate about this, over the last four years we’ve seen over 50,000 patients,” he said. “If I look at my career, I don’t know if I would have achieved 50,000 in an office. So, in my mind, how many more patients have we helped? It’s a great accomplishment, but we have so much more to go.”

Providers around the state are advocating for a bill in the NC General Assembly (HB 149) that would require insurance plans cover care provided to patients through virtual visits. Contact your local representative about expanding telehealth services in North Carolina — learn more here.