Toward a Better Understanding of Social Workers on Integrated Care Delivery Teams

This project is is supported by University of Michigan Behavioral Health Workforce Research Center and is being completed in collaboration with the University of North Carolina. 

Investigators: Lisa de Saxe Zerden, PhD, MSW; Erica Richman, PhD, MSW; Brian Perron, PhD, MSW; Brianna Lombardi, MSW

Background: Social workers are recognized as having a key role in the successful implementation of team-based models of care (Section 3502 of the Patient Protection and Affordable Care Act; American Hospital Association, 2010). From improved patient outcomes to reducing reimbursement issues to decreasing costs, there are myriad benefits of integrating primary and behavioral health care that allows for treatment of the “whole” patient. In this integrated schema, the role of social workers is particularly important. As the largest group of clinically trained mental health providers in the United States (Whitaker, 2014), social work is critical to meeting the needs of the estimated 2 million previously uninsured adults who will receive behavioral health services, many through integrated health care (IHC) settings (SAMHSA, 2014).

Due to their interdisciplinary skill set and understanding of the social determinants of health, social workers can assess and support patients; guide patients through the system; educate patients about diagnosis, treatment, and coping techniques; address behavioral, emotional, and mental issues through a variety of brief treatment modalities; facilitate connections to nonmedical resources; and advocate for patients and improve overall access to care (Andrews et al., 2013, Horevitz & Manoleas, 2013; NASW, 2005). Given the growing numbers of social workers currently employed in the healthcare system and the 20% projected growth by 2022 for the social work profession to address health care and behavioral health needs (Department of Health and Human Services, 2016), it is critical to understand the types of roles that social workers are filling as health services shift to team-based models of care and population health approaches. The Health Resources Service Administration (HRSA) awarded over $27 million to 62 MSW programs to expand the behavioral health workforce and prepare students to work in integrated health care settings (CSWE, 2014).

The capabilities of social workers is not only beneficial to patients, but to other members of the team as well. For example, if social workers are a part of health teams, physicians can then focus on physical and medical problems rather than behavioral health issues for which they likely lack expertise – especially in a system where between 30-80% of primary care visits are driven, at least in part, by behavioral health concerns (American Hospital Association, 2016).  As such, health providers are freed to perform more specific, quality care. In addition, because social workers can detect behavioral health issues early on, IHC reduces costs in that serious mental health issues may be dealt with prior to their escalation, potentially alleviating the need for medical and/or hospital services.

Specific Aims: This project will provide much needed information about the challenges confronted by social workers and the health care agencies in which they are employed. It will be co-led by the University of North Carolina-Chapel Hill (UNC) and University of Michigan HWRCs. While the many roles social workers might play in an integrated health care (IHC) setting are clear, how this actually works in practice is not. Therefore, this project will address the following specific aims:

  • Describe how social workers are being integrated into care teams and the roles social workers are filling in IHC
  • Investigate the needs and skill gaps of social workers in IHC settings and the ways in which they interact with other health professionals on integrated teams
  • Identify the challenges social workers face and the health care agencies in which they are employed to provide integrated services.
  • Identify how curricula and continuing professional opportunities can be modified to prepare social workers to work in new care delivery models

 

This project is a continuation of prior CHWRC work; information and products related to that project can be found here.