Name
Beyond the Warm Handoff: A Mixed-Methods Evaluation of Integrated Behavioral Health in a Rural Charitable Clinic
Description

Integrated behavioral health improves outcomes and reduces healthcare utilization, yet little research examines how IBH functions in rural charitable clinics. This session describes the implementation and evaluation of an IBH program within a rural Appalachian charitable clinic. Using a mixed-methods design, data from electronic medical records patients, patient satisfaction surveys, interprofessional team surveys, and patient and provider interviews were analyzed. Results show high patient satisfaction, strong perceived impact on emergency room avoidance and work stability, and improved team collaboration, while also identifying challenges to program implementation. Participants will leave with practical insights into adapting IBH models, selecting appropriate outcome measures, and collaborative program evaluation processes in rural settings with an underserved patient population.

Speakers
Jesse Gilreath, DSW, LCSW
Laura Trull, PhD, MSW
Mary Jo Hedrick, PhD
Co-Authors
Madeline Shipley, BSW, MSW Student, East Tennessee State University, Johnson City, TN
Garrett Orick, MS4, Quillen College of Medicine, Johnson City, TN
Content Level
Intermediate
Tags
Primary Care Behavioral Health Model, Rural, Underserved populations such as LGBTQ+
Session Type
Poster
Objective 1
Describe a mixed-methods approach to evaluating integrated behavioral health in a rural charitable clinic.
Objective 2
Discuss practical steps for implementing flexible IBH models in underserved communities.
Objective 3
Identify strategies for collaborative program evaluation and team-based processes, including data sharing, workflow integration, and stakeholder engagement.
Content Reference 1

Darnell, J. S., Perry, M., Lamoureux, N., & Lee, E. (2022). Don’t Let Perfect Be the Enemy of Good: A proof of concept for a custom national data repository of quality measures for free and charitable clinics. Health Equity, 6(1), 708–716. https://doi.org/10.1089/heq.2022.0078

Content Reference 2

Hostutler, C., Wolf, N., Snider, T., Butz, C., Kemper, A. R., & Butter, E. (2023). Increasing access to and utilization of behavioral health care through integrated primary care. Pediatrics (Evanston), 152(6), 1. https://doi.org/10.1542/peds.2023-062514

Content Reference 3

Stephens, K. A., van Eeghen, C., Zheng, Z., Anastas, T., Ma, K. (Pui K., Prado, M. G., Clifton, J., Rose, G., Mullin, D., Chan, K. C. G., & Kessler, R. (2025). Intervention stage completion and behavioral health outcomes: An integrated behavioral health and primary care randomized pragmatic trial. Annals of Family Medicine, 23(1), 35–43. https://doi.org/10.1370/afm.230576

Content Reference 4

West, K., Ceesay, B., Razetto, O., Cho, S. M., Newport, C., Hunter, A., Mittal, K., Lee, K., Otero, S., Johnson, D., Miller, D., & Yohanna, D. (2025). Promoting a clinic-based approach to behavioral health integration and serious mental illness in free and charitable clinics through Project ECHO. Community Mental Health Journal, 61(7), 1238–1244. https://doi.org/10.1007/s10597-025-01461-0

Content Reference 5

Williamson, M., Jackson, K., Wade, L., Lopez, C., Nanavaty, N., Regan, T., Nouzovsky, A., Roberman, S., Garney, W., & McCord, C. (2022). Training health service psychology students in an in-person and telehealth integrated behavioral health services delivery model in primary care. Families Systems & Health, 40(4), 572. https://doi.org/10.1037/fsh0000752