Q&A: Integrated Behavioral Health models and the Sí Texas Project

By Anne N. Connor, director of community grants

In 2014, Methodist Healthcare Ministries of South Texas, Inc. launched the Sí Texas Project: Social Innovation for a Healthy South Texas (Sí Texas Project) with support from an unprecedented federal investment of $10 million by the Social Innovation Fund, a program of the Corporation for National and Community Service. Through the Sí Texas Project, Methodist Healthcare Ministries is evaluating nine evidence-based models of Integrated Behavioral Health (IBH) care, with some innovative aspects targeted at 12 counties within Methodist Healthcare Ministries' service area.

Q: Why Integrated Behavioral Health?
Methodist Healthcare Ministries' mission is to improve the health of those least served, in mind, body, and spirit. This holistic approach is reflected in IBH models, which bring collaborative teams of providers together to care for the whole person, addressing behavioral health and primary care not just under the same roof, but in a coordinated manner. Research has shown that an integrated approach leads to better health outcomes for patients, and there is a large incidence of comorbidities (co-occurring health issues that cross between mental and physical) in South Texas, so the need is there. Methodist Healthcare Ministries is also developing its own IBH team at its owned and operated clinics, a reflection of our commitment to this approach.

Q: How do you balance "evidence-based" with "innovative"?
Sí Texas Project subgrantees started with models that had been proven effective, and modified them to be more appropriate for their local needs (such as for Hispanic border populations or rural populations). We are interested to see if these modifications help the models to be more effective here. It is part of the Social Innovation Fund's purpose to "support innovations that have advanced beyond the beginning stages, are showing signs of effectiveness, and have the potential for greater scale."

Q: How are you evaluating the models?
A: Methodist Healthcare Ministries has engaged Health Resources in Action (HRiA) to evaluate each model. Each model is being evaluated using either a Quasi-Experimental Design (with control groups) or a Randomized Controlled Trial (with random assignment), with robust research methodology and statistical analysis to back it up. Methodist Healthcare Ministries also built its own capacity by forming an internal evaluation team to interface between Methodist Healthcare Ministries and the subgrantees.

Q: What will you do when you find out which models work best?
A: The first phase of the Sí Texas Project is building evidence for the models. In the second phase, scaling what works, we will fund expansion of the most effective models, whether through the agencies already employing them, or by offering other subgrantees the chance to apply them.

Q: What are the nine models?
A: The nine IBH models will be showcased individually through a series of articles to be added to the Methodist Healthcare Ministries Blog over the next few weeks to introduce each model. To stay in the loop, please subscribe to the Blog at www.mhm.org/blog.