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First Stop Initiative improves access to mental and behavioral health care

BHOP’s First Stop Initiative makes it easier for patients to address mental and behavioral health concerns right at their primary care clinic. This allows for the patient to easily address any stressors before they become a bigger problem and where additional care can be coordinated for them.

FALLS CHURCH, Va. -- Navigating a complex healthcare system and seeking out a mental health specialist can be overwhelming and time consuming. As a result, many are reluctant to address treatable mental health concerns. To make it easier for patients, the Air Force has implemented a program called First Stop Initiative, making the primary care clinic the first stop for all mental and behavioral health concerns.

Behavioral health refers to the psychosocial aspects of any medical condition, which also encompasses mental health. Essentially, it deals with a wide range of issues from the inability to adhere to a treatment plan and job stressors, to screening for potentially serious mental health disorders. Seeking out help for behavioral health issues does not always mean a patient has a mental health disorder.

The First Stop Initiative addresses behavioral health by making it accessible through primary care, via the Behavioral Health Optimization Program.

“Instead of a patient going straight to a specialty mental health clinic, BHOP and primary care is literally the first stop for patients to receive care,” said Col. William Isler, the program manager for BHOP and psychology consultant for the Air Force at Joint Base San Antonio-Lackland, Texas. “This approach is easier and less time consuming for patients, who often find it less invasive than scheduling a specialty appointment. Often, BHOP visits are enough for a patient to address their concerns.”

The stepped-care approach ensures that patients receive the appropriate level of behavioral care for their needs at a location that is easily accessible and known to them. They visit their primary care clinic and speak with an internal behavioral health consultant about any concern they might have. From there, it can be determined if more care is needed but patients often find that just one consultation is enough.

“Appointments with IBHCs are much quicker and do not take more than 30 minutes,” said Dr. Mario Nicolas, a clinical neuropsychologist and the deputy program manager for BHOP. “Even better, the patient does not have to schedule an appointment since we can frequently accommodate walk-ins.”      

Each Air Force MTF has at least one IBHC who is ready to speak with patients about a variety of issues they might be dealing with. These consultants usually are social workers or clinical psychologist who are equipped to address behavioral health issues. This could include addressing habits, behaviors, thoughts, or even emotions.

“We find that the initial primary care IBHC appointment completes much of the background information a mental health specialist would collect,” said Nicolas. “That way, when it is needed, the specialist can have a more informed appointment with the patient.”

First Stop can also help patients to follow through with recommendations from their providers and even address behavioral issues before they become an even bigger problem. Using a collaborative approach, patients are involved with coming up with solutions they think will work for them. By focusing on the patient’s strengths, they are more likely to follow through with the solutions, and, in turn, have improved health outcomes. 

“In our specialty mental health clinics, it often takes a while to go through the process of scheduling, making referrals, setting appointments, and all the paperwork,” said Isler. “This can be challenging for patients and providers. Using BHOP makes it simpler and less time consuming to receive care. Please consider making BHOP in primary care your First Stop for all behavioral health needs.”