Expanding our Network: Increasing Access to Specialized Mental Healthcare through an Integrated LCSW position.

Abstract:

Background: There is increasing evidence that an individual’s health outcomes are influenced by environment [1]. Mental health care is equally affected by environmental and residential factors, including socioeconomic status, physical environment, social networks, and access to healthcare. Studies have shown that less affluent and more rural areas are correlated with greater mental health distress [1]. Regional differences and disparities in social determinants of health (SDOH), including the social, cultural, and economic environment, influence patient outcomes [2]. Integrated mental health treatment are options to increase access for individuals in underserved areas.

Methods: We identified patient care outcomes of an integrated care model with a licensed clinical social worker (LCSW) specifically for oncology patients. Our cohort included adult patients who were seen at Cancer Center locations outside the primary academic center. We reviewed referrals from January through December 2023. Retrospective data will be obtained through IRB approved chart review. We will identify patient demographics, geographic location, reason for consultation, treatment recommendations, and follow up care, based on documentation in the electronic medical record.

Results: Data collection and analysis are in progress and will be completed by summer 2024. In this review, we will identify demographic and regional data focused on underserved areas. Preliminary data demonstrates that after establishing the LCSW position, the number of network referrals from community and non-urban locations increased. Of all referrals, over half of patients were scheduled with a psycho-oncology provider, and 75% of those individuals scheduled were seen by a provider. Of these patients, 25% were seen by a C/L psychiatrist in the psycho-oncology clinic. 62 distinct patients were seen by integrated LCSW for therapy with a notably low show rate of 7%.

Discussion: Increasing access to quality healthcare, especially in rural and underserved areas, requires expansion beyond traditional health care models. Integrated behavioral health teams are designed to address discrepancies in access to care and improve patient outcomes [3]. As members of an integrated team, social workers can provide a variety of services to address SDOH, including care coordination, case management, counseling, psychoeducation, caregiver support, and additional provider referrals. Including social workers improves overall health outcomes, reduces service utilization, improves healthcare costs, and leads to increased patient quality of life [4].

Conclusions: Integrated members of care teams, including LCSWs, can expand access to services in specialized mental health care in medical settings, including therapy and medication management.