Integrating Physical and Behavioral Health at Yale New Haven Hospital

Behavioral health1 disorders can increase the complexity of a patients’ care and outcomes. At Yale New Haven Hospital (YNHH), a cutting-edge model brings behavioral health treatment to support medical teams before crises can arise.

In some YNHH settings, leaders say that more than 50% of patients presented with psychiatric and/or substance use conditions. In response, Yale leaders launched a Behavioral Intervention Team (BIT) at Yale New Haven Psychiatric Hospital in 2012 and, in 2015, expanded the program across YNHH’s medical and surgical units. Under this model, medical teams — including psychiatrists, nurse practitioners, advanced practice registered nurses, clinical nurse specialists and psychiatric social workers — collaborate to identify and address patients’ behavioral health needs early in their care journey. Then, behavioral health specialists from the BIT liaison with patients and their medical teams to provide behavioral health interventions.

“Having behavioral specialists as part of the service and the team is critical,” says Ariadna Forray, M.D., and associate professor of psychiatry; chief, psychological medicine section, psychiatry at NHH. “It’s not like the traditional reactive consultative service; it’s a whole-team approach.” As a result of these efforts, patients seen by the BIT had reduced lengths of stay, incurred fewer costs, and staff anecdotally reported a boost in their own job satisfaction.

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