Meeting mental health needs – where patients are most receptive
When Elena Reyes arrived in Southwest Florida in 2012 , she asked a local hospital about the dearth of clinical psychologists .
Directing the College of Medicine ’ s efforts in Immokalee , and through her engagement with the school ’ s family
Reyes medicine residency at Lee Health in Fort Myers , Reyes quickly assessed the need , and as quickly proposed a solution .
“ My recommendation was that we do this as integrated care – a cutting edge approach where you ’ re introducing a psychologist inside of a primary care setting and they ’ re working as a team for chronic disease management apart from the traditional approach to mental health ,” said Reyes , a clinical psychologist who specializes in pediatric psychology and Latino mental health and integrated care .
“ This is called population health – you ’ re trying to take care of a community and you ’ re trying to not go into that model of fee-for-service , but rather a psychologist is part of the primary-care team and your return on investment comes out in the long run when you have less kids with asthma who have an attack because of their anxiety and it ’ s exacerbated to the point of going to the emergency department , or the diabetic whose condition is out of control because they have not been managing it properly .” A decade later , the outlook is better . With generous financial support from the Naples
Children ’ s Education Foundation , Reyes developed a clinical health psychology fellowship program . She recruited bilingual postdoc clinical psychologists and implemented a two-year training program at the Isabel Collier Read Medical Center , the College of Medicine ’ s training site in Southwest Florida . Fellows are placed either at the Lee Health System in Fort Myers , or at the Healthcare Network in Immokalee . The program is a member of the Association of Psychology Postdoctoral and Internship Centers .
Of the first 21 fellows accepted into the program , 19 have completed it . Thirteen remained in Southwest Florida to practice in integrated care and three others are practicing elsewhere in Florida . Three have joined the College of Medicine faculty in Southwest Florida and serve patients in integrated care . Six fellows are currently enrolled in the training program .
When Reyes arrived as the College of Medicine ’ s
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regional director for Southwest Florida , there was no such thing as having a psychologist available to work with patients who went for a primary care appointment . Today , it ’ s common practice in an area that , not unlike many parts of Florida , has a glaring need for more mental health services .
About 80 % of patients in any setting who are referred to a psychiatrist or psychologist outside the practice do not follow through with an appointment . The stigma , the unfamiliarity , the uncertainty all factor in . It ’ s especially true in the migrant farmworker community of Immokalee , but having a psychologist as part of the primary-care team is making a difference .
“ We know that this model of integrated care works well with the underserved populations that are less likely to go and seek he lp from the psychiatrist or psychologist ,” Reyes said . “ They know and trust the primary care providers .”