Dr. Anthony J. Billittier


By Anthony J. Billittier IV, MD, FACEP

Lack of access to behavioral health treatment is not unique to our region.

Nationwide, patients struggle to gain access for treatment of their mental health diagnoses. Couple that with the fear of stigma for seeking treatment, and suddenly, you have a real crisis.

We know that patients with chronic physical health conditions and comorbid mental health diagnoses have poorer outcomes than patients with chronic illnesses alone. These patients tend to be more likely to smoke; are far less likely to be compliant with medication regimes; and are less likely to engage in self-care.

The lack of access and the lack of quality outcomes gave birth to collaborative care, a model that treats patients for both physical health and mental health, ideally, in a single location utilizing a team approach. While this can be a highly effective model, it is challenging and costly to implement for most organizations.

This is where the Delivery System Reform Incentive Payment (DSRIP) Program seeks to support collaborative treatment models. Our Behavioral Health Integration Model 1 Project (integrating behavioral health services at a primary care location) represents increased care of some mental health conditions (e.g., depression) by the primary care provider along with the colocation of services through relationships and technology for sicker patients. This project will near its completion this fall, and we still have much work to do.

However, the Millennium team has made significant strides within the behavioral health integration-model 1 project.

A workgroup of local psychiatrists and primary care physicians have developed and approved a “best practice” around screening and treating depression in the primary care setting. These best practices have several important purposes.

  • First, they align our partners’ activities with high value quality measures that are critical to DSRIP’s success.
  • Secondly, they provide an easy-to-follow evidenced-based blueprint that standardizes screening and treatment for depression, which could otherwise vary significantly from office to office.
  • Lastly, they represent our initial step to enhance our primary care physicians’ ability to treat more patients in their offices, and preserve limited behavioral health resources for more challenging cases.

To this end, the Millennium team will be working to further strengthen relationships between primary care and behavioral health partners over the next six to eight months. Concurrently, we will be working closely with our primary care physicians to support their adoption and implementation of these best practices.

Millennium hosted “Cardiovascular Disease and Behavioral Health-Putting the Pieces together”, a learning/credit event for primary care providers March 22 at Giancarlo’s. Speakers included (above from left) Dr. Susan Graham, MD, Professor, Department of Medicine and Cardiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences; Dr. Kim Griswold, MD, Associate Professor, Department of Family Medicine, Psychiatry, Public Health and Health Professions; and Dr. TammieLee Demler, B.S., Pharm.D, MBA, BCPP, Psychiatric Residency Program Director, University at Buffalo School of Pharmacy and Pharmaceutical Sciences

View a replay of the presentation on the Millennium YouTube Channel here: https://www.youtube.com/watch?v=FQuiT3gbL7g&t=1346s


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