Imagine a primary care doctor treating a patient struggling with grief, or addiction, or the aftermath of trauma.
If she’s in an integrated health care setting like Penn Medicine Lancaster General Health (LGH), she’d likely connect her patient with a counselor—maybe Terry Carrilio, Ph.D. ’79, or David Eisenberg, M.S.S. ’74, Ph.D. ’80, who both serve as licensed behavioral health counselors embedded in several of LGH’s primary care practices.
A relatively new idea in the medical field, integrated behavioral health care replaces a system that siloed primary and behavioral health care. Instead, it treats the whole person in one setting for medical conditions and related behavioral health factors.
“At LGH, mental health clinicians collaborate with their family practice colleagues—physicians, physician’s assistants, nurse practitioners, and nurses—to address the behavioral health needs in primary care,” says Carrilio. “We share adjacent provider rooms, enter data into a unified patient medical record, and have ample opportunity to informally discuss the patient’s needs and treatment approaches with each other.”
Carrilio and Eisenberg met as students at the GSSWSR, married, and followed parallel career paths to California. Carrilio worked in family service agencies and pursued an academic career at San Diego State University School of Social Work. Eisenberg took an unconventional route: “Always interested in policing,” he explains, “I started wondering if the social work values and skills I learned at Bryn Mawr could be applied to the difficulties identified in American policing. I joined a police department and spent the next 16 years working as a street cop but looking at the nexus between community, police, and mental health.”
After a stint in D.C., the couple moved back to Pennsylvania, where, as serendipity would have it, yet another GSSWSR grad was looking to hire. For Caroline Thomas Barnhart, M.S.S. ’99, Carrilio's arrival on the scene—just as the LGH program was expanding—was a touch of “cosmic karma.”
As manager of Integrated Behavioral Health at LGH, Barnhart supervises a staff of 41 and oversees the implementation and quality management of integrated behavioral health in more than 30 primary care and specialty care sites in the Lancaster area.
Barnhart has had a varied career, with gigs in summer youth employment and training programs; in legal advocacy organizations for older adults; in medical social work in hospitals, outpatient dialysis, and homecare and hospice; and in a social work education program on the Cheyenne River Reservation with the Lakota Sioux. She even undertook training as a yoga teacher, including a residency at an ashram in Mumbai.
In her current role, Barnhart leads the effort to improve behavioral health service delivery, including efforts to increase access, assure quality, reduce stigma, enhance collaboration, and improve patient outcomes. “This opportunity has afforded me incredible career satisfaction in improving the landscape of behavioral health in the community,” she says, “and in creating a team of incredible talent—including Terry, David, and their colleagues, with whom I am privileged to work—on changing the world!”
The Patient Benefits
Chronic health conditions might not improve until associated behavioral health concerns are addressed. Convenient “one-stop shopping” makes treatment more accessible. Many patients referred to other places for behavioral health treatment do not follow up. When mental health and substance-use disorders are addressed, work-related productivity improves. Integrated behavioral health might allow clinicians to provide services to those who might go underserved.