‘new paradigm’ A
A 12-year-old boy with stomach pains. A 50-year- old woman with fibromyalgia. A 40-year-old heart attack survivor who seems to run a meth lab.
These aren’t the type of patients who usually show up in a
psychologist’s office. But for those who work in community
health centers, treating such patients — as well as those with
standard mental health issues — is just part of a typical day’s
work, said Dennis Freeman, PhD, chief executive officer of
Cherokee Health Systems in Knoxville, Tenn.
Freeman and others spoke about psychologists’ work as
part of interdisciplinary teams at community health centers
at APA’s 2011 Education Leadership Conference.
In 1969, when Freeman began working in a community
mental health center in Tennessee, such facilities played a key
role in providing services to the underserved and training
to psychologists. But today those roles are fading away, said
Freeman, citing shifts in state and federal policies, budget
reductions and waiting lists.
Fortunately, “federally qualified health centers (FQHCs)
are thriving,” he said. But while nearly three-quarters of
FQHCs provide behavioral health services, only 112 of the
1,000-plus centers employ a psychologist and just 46 train
Cherokee is one that fulfills both missions. The
organization, which began as a community mental health
center, is now an FQHC as well, creating what Freeman
“If we can really integrate behavioral health into primary care,
that’s a game changer,” said Dr. Seiji Hayashi, chief medical
officer in the Bureau of Primary Health Care at the U.S. Health
resources and Services Administration.
called “a hybrid safety net organization.” Behavioral health
consultants — almost always psychologists — are an integral
part of Cherokee’s primary-care teams and provide real-time
assessments and brief interventions to address behavioral
health issues related to asthma, diabetes, hypertension,
mental disorders and other conditions.
“This isn’t traditional psychotherapy co-located in a
primary-care office,” Freeman emphasized. “It’s a new