Mr. Micoli is vice president of behavioral health at Marlton, N.J.-based Virtua Health. The health system has worked to integrate behavioral health services at all of its primary care centers, and is working to bring behavioral health in closer harmony with specialty care, he said.
Mr. Micoli will speak on the panel “Building Effective Integrated Care Models for Behavioral Health Patients” at Becker’s Behavioral Health Summit. He caught up with Becker’s to explain why integrated care is the top trend he’s watching in 2025.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What are the trends that will shape 2025 in behavioral health?
Russ Micoli: Continuing to drive integration between physical health and behavioral health, mental health and substance use is something we’re definitely focusing on. That will continue to be at the forefront, as far as trends go.
Q: What are you focused on in particular this year when it comes to integration?
RM: We have pretty elaborate behavioral health-primary care integration. We’ve got 28 primary care practices, and we’re providing psychiatric support services at all of them. We have social workers that are embedded in a majority of those practices, and then we have psychiatry and advanced practice nurses available for consultation with the primary care providers.
One of the things we’re doing this year is expanding that into our chronic disease management program to the greatest extent possible. Our center for liver disease has folks that are in need of a liver transplant for alcohol use. We help manage the patient in preparation for the transplant, so they get to the point where they can qualify. Post-transplant, we will continue treatment to help them maintain their recovery.
Integration is very much on our radar and at the same time, we’re continuing to work with our emergency department and our medical units to make sure that we’ve got a well-greased referral process for patients that are coming out of the hospital and in need of services.
Q: What are the biggest challenges in integrated behavioral health and other forms of care?
RM: One of the biggest challenges facing behavioral health is we don’t have sufficient infrastructure to meet the demand. I think that’s contributing to a lot of the problems we’re seeing. I don’t think I’m speaking just for New Jersey when I say that we just don’t have the workforce or the resources to meet the demand. It was exacerbated by COVID, but prior to COVID it was still a significant issue. COVID pushed it beyond where anybody would have imagined.
[The challenge] really is around payment, reimbursement [and] benefit structure. The issues therein are that, the more complicated or costly it is for individuals to have their emotional wellbeing addressed, the less likely it is they’re able to follow through.
Behavioral health is an underlying condition in every diagnosis. Years ago, Prego tomato sauce had the tagline ‘it’s in there.’ Well, behavioral health, it’s all in there. It’s in cardiology — all the specialties — there’s a place where behavioral health impacts the onset or management of those chronic diseases. The inability of people to access care complicates, not only their mental health, but their overall health in general.
