About Health Navigation

Intervention Model

Many programs that serve people with mental illness presume that consumers need someone else to manage things for them. At Pacific Clinics, we believe that the best care comes from an empowered consumer. Certified Health Navigators train consumers with serious mental illness to self-manage their healthcare. Unlike specific disease treatment models, where individuals are taught to deal with a single disorder such as diabetes or cancer, the Health Navigator Program is a comprehensive healthcare engagement and self-management model, where consumers are taught the skills to access and self-manage their healthcare effectively. The intervention is comprehensive as it connects people to preventative, primary and specialty healthcare services.

Self-management refers to Health Navigators empowering and training consumers to be assertive and effective self-managers of healthcare services so that their interactions with care providers can be more effective. This is also an in vivo (in the "real world") approach that develops self-management skills in real world healthcare settings. The in vivo approach is important because these settings are ideal for teaching self-management skills that are sustainable. The Health Navigation Intervention Model is: "For Them, With Them, By Them" designed to provide consumers with the services, skills and knowledge to empower consumers to self-manage their healthcare needs.

For Them - Health Navigators perform tasks with consumers as consumers observe

With Them - Consumers perform tasks and Health Navigators coach them as needed

By Them - Turn it over to the consumer to self-manage healthcare with support as needed

What Is A Health Navigator?

Health Navigators are crucial to the implementation of healthcare reform in providing integrated services. Health Navigators are behavioral health peers, paraprofessionals and professionals who are trained to help people with a serious mental illness self-manage their physical healthcare and wellness needs. The intervention is based on a behavioral model of health service for vulnerable populations that has been adapted for people with serious mental illness and emphasizes the recovery model. A trained Health Navigator can make a meaningful difference in the lives of people with serious mental illness.

Trained Health Navigators implement the intervention's three-tier approach:

  1. Integrating different systems of care
  2. Educating consumers about health care and self-care
  3. Building cognitive and behavioral skills that promote healthy lifestyles and improve health outcomes

Peer partners, advocates, case managers, community workers, consumers, family members, NAMI members and others are ideal candidates for Health Navigators.

Why Health Navigation Training is Necessary

For many reasons that are unique to each person, mental health consumers find it difficult to visit a medical doctor and seek help for their physical illnesses. Many of these consumers might go years without visiting a doctor despite being in poor health.

Individuals with severe mental illness experience a life expectancy that is 20-25 years shorter than that of the general population in the U.S. These individuals have higher rates of most physical and chronic illnesses but have difficulty accessing appropriate medical care as well as problems with receiving appropriate diagnosis, treatment delivery and follow-up. These factors result in poorer health outcomes for every major health condition, including high rates of chronic diseases such as heart disease, diabetes, obesity, cancer, cholesterol, and respiratory illnesses. The disparity is largely due to treatable medical conditions that often remain unaddressed.

Specifically, studies have found a higher incidence of chronic diseases and certain physical disorders, such as diabetes (Dickerson et al., 2006); Lester, Tritter, & Sorohan 2005), obesity(Parks et al., 2006), higher cholesterol or dyslipidemia (Dalmau Bergman, & Brismar, 1997), metabolic and cardiovascular problems (Brunero & Lamont, 2010; Deakin et al., 2010), and cancer(Brown, 1998) among people with serious mental illness. When combined with serious mental illness, unaddressed health care issues can lead to other health conditions (Dickerson et al., 2005) and to a lower quality of life than that of both the general population and individuals with mental illness alone (Rosenheck, Druss, & Perlin, 2002: Dickerson et al., 2008). These negative health consequences can affect other recovery goals, such as housing, vocational training, and education (Bazelon Center for mental Health Law [BCMHL], 2004).

The Health Navigation Certification Training Program is designed to train the behavioral health workforce --mental health peers, paraprofessionals, case managers, family members, NAMI members and professionals-- to help consumers "navigate" the physical health care system and thereby improve their health outcomes and life expectancy.

Health Navigation has proven to be effective. In a randomized controlled trial conducted by the USC School of Social work in collaboration with Pacific Clinics, it was found that the total number of health problems reported was significantly reduced for consumers who received Health Navigation services. Specifically, their health status improved and the preferred locus of their health care services appropriately changed from emergency room/urgent care sites to outpatient clinics, reducing health care costs.

Read more about the study here (PDF).

The training provides Health Navigators with intensive, individualized interventions that can be utilized in real-world settings that will allow them to:

  • Improve consumers' use of appropriate levels of physical care (such as accessing more cost-effective outpatient services instead of emergency rooms).
  • Improve consumers' health.
  • Empower consumers to self-manage their health care needs and use of health care services over time.

CONTACT US

For Onsite Custom Training at:
1 (877) 9-MYPCTI
1 (877) 969-7284
OR
PCTI@pacificclinics.org

Pacific Clinics Training Institute
2471 East Walnut Street
Pasadena, California 91107