health care,
education and
social services

health care,
education  and
social services

Integrated Care Improves Behavioral Health Outcomes

At Mary's Center, we're always looking for innovative ways to improve outcomes. We've recently adopted the Integrated Care model and our participants are already seeing the benefits. Therapist Gretchen Gates explains the model and shows how it helped one traumatized mother.

As an Integrated Behavioral Health (IBH) therapist, I often start work with a general sense of what the day will look like: half a dozen scheduled appointments, enough open time for warm hand-offs (unscheduled consultations or visits with participants), and some administrative time in between.  I am consistently surprised by the amount of resilience, determination, and fortitude that walks through my door each day.  This is why I love working in an integrated care setting.

Moving Forward: Maria's Story

Take Maria* as an example: Maria is a single mother of five; two of her children are here with her in the US, three still at home in Honduras.  Maria endured a physically abusive relationship in her home country and additional hardship while migrating to the United States.  Since arriving here, she works 12-14 hours per day, six days per week, in order to save enough money to bring the rest of her children to live here.

All of that hardship has taken its toll.  Maria sought care at Mary’s Center due to increasing stomach pains and headaches, difficulty sleeping, and lack of motivation to go to work each day.  Her doctor referred her to me after acknowledging that most of Maria’s symptoms could be attributed to depression and anxiety following the trauma she had experienced.   After a few sessions focused on identifying her trauma and improving her coping skills, Maria reported an increased ability to seguir adelante (move forward).

Integrating Medical And Behavioral Health Treatment

Unfortunately Maria’s story is not uncommon. Fortunately Mary’s Center has adopted an integrated behavioral health model that allows participants to receive both medical and behavioral treatment under the same roof – essentially allowing us as providers to work together in order to treat the whole person.  On any given day, I am able to provide support to individuals who come to Mary’s Center with a range of concerns, from suicidal thoughts to a new cancer diagnosis, and who might not otherwise have had the opportunity to receive treatment.  They face incredible challenges in getting behavioral health care including stigma, lack of benefits coverage, and a lack of providers close to where they live, which is why integration is so important.

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), people with serious mental illness die 25 years earlier than the general population and two-thirds of those deaths are due to preventable and treatable conditions [1].  With the integrated care model as implemented at Mary’s Center, these individuals are screened for behavioral health conditions and linked to care either with an IBH therapist or referred to Mary’s Center outpatient clinic.

Treating The Whole Person

In addition to screening and treating participants, integrated providers are able to triage the neediest clients so they receive the appropriate level of care. Since adopting the integrated model in April 2016, four behavioral health providers (one at each clinic) have received 580 referrals for behavioral concerns and have been able to triage 59 of those for higher level of care.  This means that IBH is having a favorable and dramatic impact on our ability to address the behavioral health concerns of our participants, while reserving the long-term psychotherapy services of the outpatient clinic for those with the highest need.

There is an incredible amount of work ahead in terms of identifying, de-stigmatizing and treating behavioral health conditions in our community. However, Mary’s Center is proud to say we’ve taken the first step by implementing the integrated care model and are treating the whole person.

*Name changed to protect the identity of our participant.


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 Gretchen Gates, Mental Health Therapist at Mary's Center

About Gretchen Gates, LGSW

Gretchen Gates specializes in therapy for adolescents and families. She holds a Bachelor of Arts in International Studies and Communications from University of Dayton and a Master of Social Work from The Catholic University of America. Gretchen believes it is important to decrease the stigma surrounding mental health. As someone who enjoys running, biking and playing with her dog, Gretchen recommends exercise because it benefits both the body and the mind. She also enjoys cooking and speaks both English and Spanish.



[1] Understanding Primary and Behavioral Health Integration by the Substance Abuse and Mental Health Services Administration (SAMSHA)



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