National Depression Screening Day, held annually on the Thursday of the first full week in October (6 de outubro this year), is an education and screening event conducted by hospitals, clinics, colleges, and community groups nationwide. Much like medical community screenings for diabetes and high blood pressure, the group Screening for Mental Health (SMH) wanted to offer large-scale mood disorder screenings for the public. The program provides free, anonymous screenings for depression, generalized anxiety disorder, bipolar disorder, and post-traumatic stress disorder, as well as referral to treatment resources. Screenings are held both online and in-person and thousands of people participate each year.

Depression Screening Day focuses on the importance of seeking help. Depression is a common and treatable mood disorder and spreading awareness about the different ways those dealing with it can get help could save lives. Please join us this National Depression Screening Day and help us spread the word to increase awareness of mental health.

BCBSRI supports and encourages use of the PHQ-9 for depression screening in primary care settings.

Why screen for depression in primary care?

• The USPS Task Force has issued guidelines for universal depression screenings and stated that 100% of patients should be screened annually for depression.
• Depression is one of the most common chronic conditions across the population. NAMI estimates that one in four adults at any given point in time are living with depression and that an estimated 17.3 million American adults had at least one major depressive episode in the past year.
• Screening all patients for depression in primary care can be very useful. Most providers can easily identify their patients with severe depression. However, those with mild or moderate depression often go undetected. If mild or moderate depression is identified and discussed during a primary care appointment, it can be a relief to the patient to be able to discuss their feelings openly with the primary care provider and be given treatment options. It can also help the patient create an action plan that may help them avoid more severe depression, and the need for more intensive medical care, in the future.

What do I do if my patient screens positive for depression?

As a primary care provider, you have a relationship with the patient and have the opportunity to identify depression and facilitate relief. Work together with your patient to create a comprehensive treatment plan using shared decision making. Some examples of interventions may include providing the patient with resources regarding depression and/or depression and chronic disease, or providing the patient with resources regarding medication, if applicable. You may also consider offering problem solving treatment or brief supportive counseling services within your practice.

Provide members with referrals for specialty care as needed. Not everyone with depression needs a referral for therapy. Some patients could benefit from brief interventions that could be done by a nurse case manager or other clinical staff already working in your practice. Consider options for providing supportive counseling to patients as needed, particularly as a patient is starting on a new antidepressant. It is important to stay in contact with the patient as they are managing their depression and/or other chronic conditions. Frequent check-ins with patients to provide support and education as needed will help them stay on track with managing their depression. BCBSRI behavioral health case management is also available to you as a resource for your patients. Please see below for additional information on BCBSRI’s program and other ways to connect your patients to behavioral health resources.

BCBSRI promotes integrated behavioral health in primary care settings

The Centers for Medicare and Medicaid Services (CMS) established a code set to cover the Collaborative Care Model as well as integrated behavioral health services in primary care. In the final rules, CMS put forth specific requirements that must be met in order to submit for payment using these codes. The requirements are aligned with the foundational elements of the Collaborative Care Model put forward by CMS. To ensure adherence to these requirements, PCPs must be able to demonstrate that they are providing services under the collaborative care model or in an integrated care setting by submitting a detailed program description to BCBSRI. After BCBSRI reviews and approves the program description, the provider will be reimbursed for services provided to BCBSRI members. Please refer to BCBSRI’s behavioral health integration services including the Collaborative Care Model policy.

BCBSRI will inform the provider via email notification if their program description meets requirements. Providers will be able to submit claims 60 days after program approval. No retroactive payments will be made for services rendered.

All program descriptions can be sent to Behavioralhealth@bcbsri.org.

How do I connect a patient to behavioral health services?

The behavioral health system can be confusing and overwhelming for your patients to navigate. As BCBSRI continues to expand our continuum of services for behavioral health, we realize that providers may have questions regarding the types of services available for their patients. There are several ways to learn more about behavioral health benefits and services:

• The Provider Call Center [(401) 274-4848] can answer questions regarding a member’s benefits, including their liability for services. They can also assist if you’re simply looking for a participating behavioral health provider. You can also search BCBSRI.com if you are simply looking for a behavioral health provider.
• The BCBSRI BH Clinical Referral Line is available Monday through Friday from 9 a.m. to 5 p.m. and is answered by clinical behavioral health staff. The clinical referral line can assist you in identifying a behavioral health provider, as well as providing support and guidance. The clinical referral line should not be used if there is concern of imminent danger but can be a first point of contact in non-emergency situations. The clinician, who may be a registered nurse, independently licensed social worker, or a mental health counselor will ask questions to get a better understanding of your patient’s needs. The clinician will provide you with information about services that are available and will offer the names and contact information for providers who offer these services. You can contact the Clinical Referral Line at 1-800-274-2958.
• The BCBSRI BH Intensive Case Management Program can assist your patients in effectively managing their behavioral health conditions. Independently licensed behavioral health clinicians will work with your patient to:
  • Help them understand barriers that prevent them from getting the most from their treatment or in obtaining recommended treatment.
  • Help them find and obtain services or resources needed to better manage their behavioral health condition.
  • Provide education and support to help them better manage their condition.
  • Coordinate care with providers to ensure you and your patient have the necessary information to provide them with the best care and support.
  • Work with them to ensure they know the medications they should be taking and understand the instructions you’ve provided to them.

Urgent access appointments: Child and Family Psychiatry offers urgent psychiatric evaluations and ongoing treatment administered by a child and adolescent psychiatrist. If a BCBSRI patient needs an urgent appointment, please call Child and Family Psychiatry and indicate you are looking for a BCBSRI urgent appointment. The practice will follow up with the patient to schedule the appointment and continue to provide treatment services for the patient as clinically indicated.

Please call (401) 572-3313 or contact BCBSRI behavioral health case management for more information at 1-800-274-2958.

Child and Family Intensive Services (CFIT): CFIT takes a team approach to providing developmentally appropriate services for teens and their families in the community. Services are provided to engage the client and his/her family by improving level of functioning, promoting healthy lifestyles, and teaching community integration skills. Providers include:

• The Providence Center
• Community Care Alliance
• Family Services of Rhode Island
• Gateway Healthcare
• Thrive Behavioral Health
• Child and Family Services of Newport County

Contact BCBSRI for referral information at 1-800-274-2958.

Bradley Hospital Mindful Teen: The Mindful Teen Program provides all components of DBT treatment for adolescents (individual and family therapy, multifamily skills training, phone coaching, and clinician participation in a DBT consultation team) in an outpatient setting. This program serves adolescents with suicidality and/or NSSI who are either stepping down from or are at risk of being admitted to a higher level of care (such as inpatient, partial hospitalization, or intensive outpatient). The Mindful Teen program is designed to provide adolescents with the necessary skills to manage their emotions, tolerate distress, and manage interpersonal stressors more effectively, while at the same time allowing them opportunities to practice and generalize these skills in their lives outside of treatment.

Such opportunities for skills practice and generalization over an extended period are vital for preventing further high-risk behaviors and subsequent admissions to higher levels of care, due to adolescents lacking the skills they need to manage their day-to-day lives safely and effectively.

Please call (401) 432-1081 or contact BCBSRI behavioral health case management for more information at 1-800-274-2958.

HealthPath: HealthPath is a home- and community-based service for adults offered through Butler Hospital. HealthPath is designed to provide BCBSRI commercial members with comprehensive behavioral health services. The program offers a multidisciplinary team approach including psychiatry, nursing, independently licensed clinicians, peer support specialists and substance abuse specialists who provide office, home, and community-based services based on members’ identified needs. The services are intended to assist members struggling with behavioral health conditions in reaching their highest level of functioning through a coordinated and individualized treatment approach.

Please call (401) 415-8868 or contact BCBSRI behavioral health case management for more information at 1-800-274-2958.

BH Link: BH Link provides BCBSRI members with a 24/7 clinical triage line to connect people to care and resources during a crisis. This is a 24/7 community-based walk-in facility that connects people with immediate behavioral health services and recovery supports.

Please call (401)-414-LINK (5465) for 24/7 assistance in person or via phone.

Kids’ Link RI: Kids’ Link RI provides care for children and youth in need of mental health services. Kids’ Link provides a 24/7 clinical triage line to connect children and youth to care and resources during a crisis.

Please call 1-855-543-5465 for 24/7 assistance via phone or contact BCBSRI behavioral health case management for more information at 1-800-274-2958.

To refer a patient to the BCBSRI case management program, please call 1-800-274-2958, option 2. You may also use the automated referral form at BCBSRI.com by following these easy steps:

1. Log on to the provider portal of BCBSRI.com.
2. Click on Tools and Resources.
3. Click on Forms.
4. Click on Case Management Request.
5. Complete the required fields and click Go!

If your office is looking for more information regarding depression screening and follow up, please contact Sarah Fleury, LICSW, CPHQ, BCBSRI director of behavioral health, at (401) 459-1384 or sarah.fleury@bcbsri.org.