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Persistent or severely mentally ill will now receive a little extra care

The World - 1/4/2019

Jan. 03--COOS COUNTY -- Coos Health and Wellness is making it easier for clients to get treatment.

CHW has partnered up with North Bend Medical Center's immediate care clinic to bring on a doctor once a month to see severe or persistent mentally ill patients.

"We are primarily a specialty behavioral health organization, which constitutes a variety of things, but when it comes to our severe and persistent mentally ill population they tend to neglect their physical healthcare," said Eric Gleason, the health care integration and promotion director for CHW. "They have a harder time getting into see their primary care provider for various reasons because they don't feel comfortable, may get kicked out because they don't assimilate well with other people since they may be louder, have a harder time getting their point across. They are historically terrible with their own care."

The Physical Health Integration Team program makes it possible, which is when public health and physical health work together for a client. Gleason compared it to the standard integration at NBMC, where a counselor works with a primary care physician's office when they see a patient with a co-morbid condition like diabetes.

"The lifestyle changes around that can be hard to deal with and if you just find out you have it there can be lots of things that come up with it," Gleason said, adding that the counselor will look at different diagnosis or visit types and get 15 minute spots with them to mitigate other appointments they might need.

It creates what he called a "one-stop-shop."

The PHIT program has brought on provider Laura Kent from NBMC's immediate care clinic to do this, as well as a nurse to spend one Tuesday a month with program clients. They provide appointments for case managers who target their most in-need patients.

According to Gleason, they pinpoint which patients are in most need to see Kent by looking at their history. If a client hasn't seen a primary care physician in a year, has diabetes, hypertension, or are high emergency department visitors, they are scheduled to be seen on that one Tuesday a month.

"We have case managers who know these people, see them, and understand what these people are working with," Gleason said. "They come in on Tuesdays and they have 45 minute appointments with them to get down to the brass tacks of what's going on. Laura takes the time to get to know and understand them."

The PHIT program has been making this possible since the fall and Gleason has heard great feedback from the clients.

He recalled one man who had a wrist sprain he had been suffering from for a while. Kent talked with the client, told him CHW would order a wrist brace, sent that information to NBMC and by the end of the day gave it to the case manager who handed it to the client that evening.

"He said to her, 'I actually felt like I was treated like a human,'" Gleason recalled. "It's hard and shouldn't be like this."

Gleason explained that CHW is able to set up extended appointments while regular clinics don't have that ability, which makes it hard for these people to integrate into the average system.

"It's why they use the ER so much, because they don't feel like they know where to go," Gleason said. "We hope we can help this population find more peace as far as physical health is concerned."

Gleason hopes to expand the PHIT program's appointment days to Fridays and possibly have a walk-in day to close the gap for individuals using the ER.

"That way we can also see them before the weekend starts and get answers for them," he said. "We feel good about this direction. I know we can make an impact on this population. Integration health care, a one-stop-shop approach, is the future of healthcare."

Reporter Jillian Ward can be reached at 541-269-1222, ext. 235, or by email at Follow her on Twitter: @JE_Wardwriter.


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