Proactive C-L Psychiatry applies the principles of integrated care to the general hospital setting.¹ Over the past decade, its primary goals have been to operationalize this model’s core principles and make a business case.² Growing experience, though, has led to an appreciation of how proactive C-L can change hospital culture.



Mental illness is associated with stigma even among health professionals,³ contributing to hospital culture. Proactive C-L services, which engage the full complement of hospital unit staff, can address negative attitudes by fostering a culture of mental health awareness. In many ways, this is analogous to the model of “patient safety culture.”⁴ Sponsored by the proactive C-L SIG, this session will re-purpose five dimensions of patient safety culture to explore how proactive C-L promotes a culture of mental health awareness, thereby combatting mental health-related stigma.



Perceptions of safety: Dr. Oldham (University of Rochester) will provide an overview of how the principles of proactive C-L psychiatry can influence hospital culture. He will also discuss how the domains of patient safety culture apply to mental health awareness in hospital settings, focusing on the domain “perceptions of safety.”



Openness to communication: Dr. Robinson (University of Maryland) will present on his team’s efforts to promote awareness of common mental health needs of hospitalized patients by developing educational resources. He will review how proactive C-L can replace the “what are we supposed to do about that?” attitude with an increased readiness to accept psychiatric recommendations.



Teamwork: Dr. Kugler (University of Texas, Austin) will discuss 3 ways that proactive C-L employs teamwork in a level 1 trauma center—teamwork within the proactive C-L team, with the traditional C-L team, and with the hospital care team—and how these collectively promote mental health awareness. He will review practical ways of implementing proactivity to enhance patient safety and care delivery.



Perceptions of mental illness: Dr. Anderson (University of Pennsylvania) will discuss her team’s work on the neurology floor. Since familiarity can enhance positive views of patients with certain mental illnesses, one way that proactive C-L affects hospital culture could be its routine prompting of teams to consider the mental health of their patient, therefore destigmatizing mental illness.



Approaching institutional priorities as opportunities: Dr. Triplett (Johns Hopkins) will discuss how his team has leveraged the flexibility of proactive C-L to meet shifting institutional priorities. He will review several ways in which the flexibility of this model has contributed to a broader institutional awareness of mental health needs and the value of integrated mental health care in acute settings.



Discussion: We would welcome the opportunity to present this live for Q&A and discussion.



¹Sharpe 2020 PMID 32592995

²Oldham 2021 PMID pending, DOI 10.1016/j.jaclp.2021.01.005

³Rao 2009 PMID 19291157

⁴Reis 2018 PMID 29788273