Evidence-Based Practices to Behavioral Health

The Chronic Care Model (CCM) has also been adapted by The National Program Office for Depression in Primary Care (http://www.wpic.pitt.edu/dppc/), to develop a clinical framework for all partnering organizations to follow. Its Flexible Blueprint was developed after a review of published interventions used to treat depression, interviews with a variety of primary care physicians, mental health specialists and other experts in the field, and selected site visits to view elements of the Chronic Care Model in action.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is supporting the Implementing Evidence Based Practices Project. This project is focused on people who have severe mental illness; these people are most frequently served in the public mental health system (http://www.mentalhealthpractices.org/).

There are six areas that have been researched. Toolkits have been developed based on the multi-state demonstrations that have been underway. The six areas are described below, based on the website materials:

Illness Management and Recovery -

This is a program of weekly sessions where specially trained MH practitioners help people develop personal strategies for coping with mental illness and moving forward in their lives. The program emphasizes helping people set and pursue personal goals and become better able to realize their vision of recovery.

Medication Management Approaches In Psychiatry (Medmap) -

This focuses on using medication in a systematic and effective way, providing guidelines and steps for decision-making based on current evidence and outcomes, monitoring and recording information about medication results, and involving consumers in the decision-making process.

Assertive Community Treatment (ACT) -

This program is for people who experience the most severe symptoms of mental illness. The goal is to help people stay out of the hospital and develop skills for living in the community. Services are provided by a team of practitioners, are available whenever and wherever needed, 24-hours a day, and are provided for as long as they are wanted and needed.

Family Psychoeducation -

This involves a strong partnership between consumers, families and supporters, and practitioners. People work toward recovery by developing better skills for overcoming everyday problems and illness-related issues, developing social support, and improving communication with treatment providers.

Supported Employment -

This is a well-defined approach to helping people with mental illness find and keep competitive employment. These programs are for anyone who expresses the desire to work. The programs are staffed by employment specialists who work with the treatment team to integrate services. They help people look for jobs soon after entering the program, and provide support as long as consumers want the assistance.

Integrated Dual Disorders Treatment -

This treatment approach is for people who have mental illness and addiction disorders, offering mental health and substance abuse services together, in one setting, at the same time. A wide variety of services are offered in a stage-wise fashion because some services are important early in treatment, while others are important later on.

The EBPs described above are intended for use in the public mental health system, serving people with severe mental illness; they are not diagnosis specific. The American Association of Community Psychiatrists (http://www.wpic.pitt.edu/aacp/default.htm) has released guidelines, such as Guidelines for Recovery Oriented Services that also address this target population rather than a diagnosis specific population.

The American Psychiatric Association has developed diagnosis specific practice guidelines (http://www.psych.org/) that are applicable in a wide variety of settings, as have other professional groups. The following list of behavioral healthcare guidelines and protocols is from the National Guideline Clearinghouse: