Behavioral and Mental Health

Most OhioHealth primary care locations have established behavioral health integration (BHI) services.

• Convenient access to behavioral health services at the patient's primary care office.
• Treatment for mental disorders like anxiety and depression.
• Short-term, one-on-one counseling sessions.
• Personalized plans for managing stress and developing coping skills.
• Behavioral health provider (BHP) meets regularly with psychiatrist/psychiatric nurse practitioner for patient review and to recommend medications.
• Referrals to psychiatrists and other specialists.

Patient with mild to moderate symptoms that impact everyday life can learn to manage their emotions effectively through BHI. Most referrals are for depression and anxiety diagnoses — which include grief, major depressive disorder and adjustment disorders. Typically, referrals are PHQ9 or GAD7 with a score greater than ten. Use your clinical judgement for patients with scores less than ten.

BHI is not appropriate for any bipolar or personality disorder, schizophrenia, delusions, hallucinations, eating disorders or a history of significant trauma. Due to possible duplication of care, it's also not appropriate for any patient who's already receiving outside psychiatry or seeing a weekly counselor. If you know a patient likely needs more consistent care than the behavioral health provider (BHP) offers, or their symptoms are chronic, refer them to social work.

Interventions are short-term with sessions ranging from 30 to 40 minutes, twice monthly.

To add an order for a behavioral health provider (BHP):

• Search for "AMB Ref to OH CM Behaviorist" or REF169
• Ensure the department is "Behaviorist (outpatient social work)"
• Accept and sign

Behavioral Health Olentangy

Transcranial magnetic stimulation (TMS) uses highly focused magnetic pulses to stimulate the areas of the brain involved in mood regulation. Research suggests that TMS causes neurons to become active, leading to the release of neurotransmitters, therefore relieving symptoms of depression.

TMS uses a technology similar to magnetic resonance imaging (MRI), which has a long-term record of safety. It’s proven effective in clinical trials and free of most side effects typically experienced with antidepressant medications, with the most common side effects reported as mild to moderate pain or discomfort at or near the treatment area.

Studies show that one in two patients suffering with depression improved significantly, and one in three patients were completely free of depression symptoms after six weeks of treatment.

TMS is indicated for adult patients being treated for major depressive disorder who have not responded to antidepressant medication. It's not indicated for bipolar disorder or other psychiatric disorders at this time. The therapy has shown to be beneficial for patients experiencing postpartum depression, and while not yet approved, may be a valuable treatment option during pregnancy.

TMS is not appropriate for primary psychiatric diagnosis with psychotic features, patients with active suicidal ideation (intent and plan), patients experiencing psychosis, patients with a PHQ-9 score less than 10, history or concern for bipolar spectrum disorder, history of seizures/seizure disorder, current substance/alcohol abuse disorder (six months of abstinence required), patient currently undergoing electroconvulsive therapy (ECT), patients with an implantable cardioverter-defibrillator (ICD or pacemaker), a history of traumatic brain injury (TBI) with chronic symptoms, reactive metal implants above the waist, patients without reliable transportation (36 treatments total requiring ten minutes each treatment).

TMS can fit into your patient’s life.

• The treatment requires no anesthesia and has no recovery period.
• A session is complete in as little as 30 to 45 minutes
• Patients receive treatment five days a week for approximately six to eight weeks
• Since patients are awake and alert during treatment, they can resume normal activities upon leaving their session.

All referrals should be made through the TMS coordinator by calling (614) 566-3388 or faxing (614) 566-6970. Patients can self-refer by calling or requesting that their provider fax their contact information. Appropriate referrals are scheduled for a consultation with the (TMS) physician.

• Behavioral Health Jerome (Fall 2024)
• Behavioral Health New Albany
• Behavioral Health Olentangy
• Behavioral Health West Broad
• Behavioral Health Westerville

Patients are generally seen as onetime consults for appropriate psychiatric diagnostic assessment and medication recommendations. Bridge services are available based on clinical need of immediate psychiatric intervention, as determined by the psychiatrist.

Referrals can be made by any OhioHealth primary care provider (OPG/COPC). We will also accept referrals from OhioHealth affiliated specialty practices. Psychiatric diagnostic assessment and medication recommendations are returned to the referring provider for ongoing management.

Referrals are not appropriate for patients with longitudinal care needs or those who need mental health wraparound services.

Onetime consult for appropriate psychiatric diagnostic assessment and medication recommendations.

Reach out to your social work team for more information. Referrals from OhioHealth affiliated providers can be made through EPIC using "Ambulatory referral to Behavioral Health (Ref 8); Psychiatric".

• Behavioral Health Olentangy
• Behavioral Health West Broad

Transition services are designed for patients in need of medication management and stabilization as well as case management services — which connect patients and families with resources for managing their psychiatric illness. These services are for patients who do not have a psychiatric physician or advanced practice registered nurse (APRN) to manage their medication, or who are not currently connected with a community mental health agency. Patients are seen by either the psychiatrist or APRN. They transition to ongoing prescribers, who may be their primary care provider or a psychiatric prescriber based on clinical need.

Referrals can be made by OhioHealth emergency departments with a patient who was seen by psychological social services while in the department's care.

They can also be made by providers at OhioHealth Riverside Methodist Hospital, OhioHealth Marion General Hospital and OhioHealth Mansfield Hospital from the following areas:

• Inpatient behavioral health (IP BH)
• Employee assistance program (EAP)
• Partial hospitalization program (PHP)
• Intensive outpatient program (IOP)
• OhioHealth McConnell Heart Health Center psychologists and behavioral health consult team (C/L)

Referrals are appropriate for patients who:

• Do not have a psychiatric physician or advanced practice registered nurse (APRN) to manage their psychiatric illness, or who are not currently connected with a community mental health agency.
• In need of medication stabilization or monitoring of psychiatric symptoms to prevent admission or readmission (i.e. as a bridge after discharge from an inpatient psychiatric admission until the first appointment with the prescriber).
• New onset of psychiatric symptoms (i.e. assessed in the emergency department).
• Acute changes of psychiatric symptoms or unmanaged chronic psychiatric symptoms.
• Patients with changes in stressors which have increased their psychiatric symptoms (i.e. job loss).

Additional services may be available for specific patient groups including referrals from OhioHealthy, neurology, hematology/oncology, cardiology and Ob-Gyn.

Referrals are not appropriate for patients with longitudinal care needs or primary substance use disorders, in addition to those requiring mental health wraparound services or who are currently established with other psychiatric care.

Transition services are short-term and last no longer than six months or until the patient is connected with ongoing services.

Reach out to your social work team for more information. Referrals from OhioHealth affiliated providers can be made through EPIC using "Ambulatory referral to Behavioral Health".

• Behavioral Health Olentangy
• OhioHealth Marion General Hospital

Referrals are appropriate for patients with symptoms of depression, anxiety and thought disorganization that affect their ability to function in multiple areas of their lives. These patients have a decrease in functioning from usual level and have demonstrated an ability to engage in and benefit from insight-oriented talk therapy. They're actively interested in learning new coping skill and ready to voluntarily participate in programming.

Referrals are not appropriate for patients with current symptoms of a primary substance use disorder. In those cases, refer to dual diagnosis/addiction services for further clarification.

Structured group setting (up to 10 patients) led by 2 facilitators (Licensed Counselors or Social Workers).

IOP: Three days per week for three hours per day, length of stay is determined by individual need (average 4-6 weeks).

PHP: 5 days per week, M-F 9:30 AM to 2 PM, length of stay is determined by individual need (average 3-4 weeks).

Reach out to your social work team for more information. Referrals from OhioHealth affiliated providers can be made through EPIC using "Ambulatory referral to Behavioral Health (Ref 8); Group Therapy".