Carolinas HealthCare System
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Carolinas HealthCare System Increasing Access to Behavioral Health Treatment

Lincoln Family Practice one of the first Carolinas HealthCare System practices in the Charlotte region to be connected to a virtual psychiatry service

Carolinas HealthCare System is working to give people better access to behavioral health services by developing a program to provide those services using telemedicine in its primary care doctors’ offices. Lincoln Family Practice is one of three System practices in the region currently offering this service.

According to the federal government, far too few people with behavioral health conditions receive the help they need.

“One of the reasons people with behavioral health conditions do not get help is they have to wait too long to get an appointment,” said John Santopietro, MD, chief clinical officer for behavioral health at Carolinas HealthCare System. “No one would accept waiting months for cancer treatment. Waiting months for mental health treatment should not be acceptable, either.”

To give patients quicker, easier access to professional behavioral health providers, Carolinas HealthCare System created a virtual network of providers that can be accessed at its primary care doctor’s offices.

“A patient that comes to see me for sleeping problems may need evaluation for depression,” said Daniel Senft, DO, board-certified family medicine physician at Lincoln Family Practice. “With this service, I can offer them a chance to immediately speak with a specialist right there, right then, in the comfort of a familiar place.”

Through the telemedicine program, the patient speaks with a behavioral health professional over a computer screen. The professional – a psychiatrist, counselor, or licensed clinical social worker – assesses the patient and coordinates the care, including helping with medication issues and making referrals to outside services.

The virtual network of services may begin with a conversation in the family doctor’s office, but it does not end there. The program also includes a health coach who calls the patient to follow up with medication changes and physician visits. The patient’s primary care doctor is also able to complete consults via the electronic medical record with a psychiatrist or pharmacist with expertise in behavioral health. In the near future the team will be offering access to on line therapy.

“The use of primary care within our system is crucial,” Dr. Senft said. “Patients trust their primary care provider and will seek support for behavioral health concerns in this setting. Having this service integrated into my practice helps me better serve my patients.”

Martha Whitecotton, senior vice president and co-leader of behavioral health at Carolinas HealthCare System is working with Dr. Santopietro to create more opportunities for people to access behavioral health services. “When mental health is integrated into primary care, people can access mental health services immediately, in a setting where stigma is minimized; improving their experience of care as well as our ability to treat the whole person, addressing both mental and physical concerns. – particularly important for a set of patients who have generally been marginalized,” Whitecotton said.

Carolinas HealthCare System plans to offer the service in all of its over 200 primary care practices.

Lincoln Family Practice began offering this service on Oct. 1, 2014.


  • More than half of people treated in this country today for their mental illness are treated in primary care
  • As many as 70 percent of primary care visits involve a behavioral issue
  • 22.7 million Americans ages 12 and older needed treatment for an illegal drug or alcohol use problem in 2013. Less than 3 million people received the specialized treatment they needed
  • Every year 15.2 million people report having a major depressive episode. Of those, more than one-third of adults did not seek professional help during the previous 12 months.

Other Sources of Information:

2010 Milbank Memorial report on “Evolving Models of Behavioral Health Integration in Primary Care”

Substance Abuse and Mental Health Services Administration

National Alliance on Mental Illness Facts and Numbers