Spreading the Primary Care Behavioral Health Model

Brian Sandoval, Psy.D."Once you show the model's utility, it grows organically in an organization," said Dr. Brian Sandoval.

He is referring to the primary care behavioral health model, which since his time at Forest, has been the focus of his career aspirations.

Sandoval recently became the Primary Care Behavioral Health Manager for the Yakima Valley Farm Workers Clinic, which is a series of community health clinics spread throughout Washington and Oregon.

"I approached one of the clinics that had an opening and told my story," said Sandoval.  "I talked to them about the possibility of not only filling the position, but making a training program around it and making it a concerted effort as part of their patient-centered medical home initiative."

Shortly after this, Sandoval found himself at the company's headquarters and before the CEO, who asked him to direct the program.

"I was confident that it was something that needed to be done, but didn't know where they were in the process and whether or not they would be able to financially make it happen," said Sandoval.

However, persistence and confidence which he gained during his internship and post-doc years paid off.

After Sandoval graduated from Forest in 2010, he did a two-rotation post doc with the University of Wisconsin and Access Community Health Center.  There he was mentored by Dr. Neftali Serrano, one of the nation's leaders in primary care behavioral health.

"That was a huge turning point in my career," said Sandoval.

He said, while under Dr. Serrano's mentorship, he learned the service delivery component, the organizational component, the leadership component, how to build a program, how to make a program sustainable, and how to work in the environment.

It was also at this time he teamed up with several others to create the first primary care behavioral health page for the popular website Wikipedia.

Once finished with his post doc, Sandoval returned to Oregon where his career took off and he began integrating the primary care behavioral health model into several clinics.

We asked Sandoval his thoughts on how hard it is to get organizations to open up to the model, and he responded saying it's a two part answer.

"First, policy is starting to push it forward.  So I think there is support growing from the top down," said Sandoval.  "From a bottom up perspective, there is a higher demand being placed on primary care providers to see a larger number of patients and a diversified patient profile, in which behavioral health naturally fits into what they are already doing."

Yet, he says you have to be passionate about the model in order to push it forward, and most importantly be aware of who you are selling it too.  Sandoval says administrators will have a much different opinion on the primary care behavioral health model than the providers who are more clinically based.

"Your administrators are going to want to know how this will impact cost, satisfaction ratings, and retention rate," said Sandoval.  "I think having a business mind and understanding your audience is really important to making this a reality in an organization."

He also says when you believe in something "you can't be afraid to walk the streets and talk the talk, or be afraid to take a risk because you never know."

Sandoval currently resides in Portland, Oregon.  He is engaged to be married this September.  He says he still enjoys making trips back to Missouri to see family, and will always remain a die hard St. Louis Cardinals fan.