Recognizing that the overwhelming number of patients with mental health conditions are treated in primary care settings, the Department of Psychiatry at Indiana University School of Medicine has launched multiple programs aimed at improving mental health care in Indiana.
Project CHOICE
Among these initiatives is the CHOICE program, which embeds psychiatrists and psychologists in three large primary care clinics in Marion County. The program is expanding to a fourth clinic this year.
Through this program, a patient with depression, anxiety or any mental health concern can be introduced on the spot to the psychiatrist or psychologist, without the inconvenience or stigma associated with a separate appointment, and appropriate follow up can be determined. Alternatively, a primary care physician can easily consult with the behavioral health colleagues on topics ranging from diagnosis to medication or therapy treatments.
In a pilot study, patients who were referred to CHOICE experienced a more robust reduction in depression than a control group of patients with behavioral health conditions who did not participate. Notably, both emergency department visits and inpatient stays increased in the control group but decreased or remained stable among those who participated in CHOICE. While these findings have not yet been published, they provide compelling evidence that this model of integrated care can be effective in Indiana, and IU School of Medicine is partnering with IU Health to expand it.