Michele Rowsome, ARNP functions as a behavioral consultant within a community based outpatient VA primary care clinic in Mount Vernon. She has worked within the VA system for 13 years.

Because of her role as ‘prescriber’ on a Primary Care Mental Health Integration (PCMHI) team, Ms. Rowsome has a built-in and vested interest in integrated care. She hopes to gain clinical skills that will help improve patient outcomes, and knowledge about how to more fully integrate with and consult with primary care providers.

Ms. Rowsome hopes that her participation in this program improves access to and quality of integrated and collaborative care for the rural veterans that she serves.

In 5 years, Ms. Rowsome sees integrated care as busier and more consultative in nature, because there will be strong buy-in from primary care providers. She also views it as a very efficient and cost-effective way to provide mental health care to people who may not be willing or able to present to a specialty mental health clinic. She feels that telepsychiatry has the potential to be an excellent avenue for connecting with patients who live in a rural setting so that they have appropriate access to the care they need.

Eric Pascual, PA-C is a newly graduated physician assistant, working at Columbia Wellness, a mental health clinic in Longview, WA.

Through Collaborative Care/integrated care, he hopes to gain knowledge about tele-psychiatry and other methods to better serve his community and the surrounding areas.

Mr. Pascual would also like to learn how to integrate psychiatric practices with primary care in anticipation of future growth of his company.

Five years from now, he would like to see a fully integrated partnership between primary care and mental health services at his job.

Janet Clingaman, MN, ARNP received her Master of Nursing degree in 1991 at the University of Washington. She has worked as a psychiatric nurse practitioner for the past 24 years in Washington state, mostly in rural community mental health centers.

Ms. Clingaman has worked in mental health settings her entire nursing career, inspired to enter this specialty by a nursing school mentor. Her first experience with integrated care was at her current job at Unity Care Northwest in Bellingham, an FQHC where she has worked for the past 4 years.

Ms. Clingaman’s interest in integrated care stems from a career working largely in isolation from the general medical community, and the challenges she had in advocating for the medical needs of her patients. Her primary patient population has been the chronically mentally ill, a population with a high burden of co-morbid health problems who encounter many barriers getting healthcare.

Her goals for the remainder of her career are to improve the integrated care program at her current job and to serve as a preceptor to future nurse practitioner students.

Jacynda Wheeler, DO, currently works at Island Hospital in Anacortes, in their Psychiatry & Behavioral Health Clinic, doing general outpatient psychiatry and working with a broad range of patients. The behavioral health clinic was established to support primary care clinics and providers in the community in providing quality mental health care.

Dr. Wheeler’s involvement in the integrated care track during residency at the University of Washington exposed her to the dynamic work going on at the interface of primary care and psychiatry. She is excited to further her knowledge in this fellowship while working to develop a more formal integrated care program at Island Hospital. She thinks we have an exciting opportunity to further our mission and improve access to mental health care by learning from the expertise and experience that the UW AIMS Center has to offer.

Dr. Wheeler is hopeful that 5 years from today, integrated care will feel more like a standard of care, and something that patients come to expect from their primary care clinics rather than feeling lucky to be part of a new program.

Vernetta Stewart, ARNP works as a psychiatric mental health consultant at Providence Everett Regional Medical Center (team includes two psychiatrists, two psychiatric N.P.s) performing mental health evaluations for patients with various co-morbidities including acute medical conditions, substance use disorders, and of course psychiatric components; prescribing psychotropic medications; advising medical providers; and making recommendations for treatment and disposition.

Ms. Stewart wishes to update her knowledge, including the use of alternative therapies on the most prevalent/effective clinical practices, psycho-pharmacotherapy, tele-psychiatry, and available community resources as well as the economic and political influences governing mental health services, especially with our underprivileged population.

Ms. Stewart’s long nursing career (as a staff RN and ARNP) has largely been centered in acute care settings in the Providence/Swedish systems and to a lesser degree in community mental health clinics. In the latter role, she has collaborated with PCPs, various agency case managers and clinicians, private practice psychiatric nurse practitioners, and of course patients’ families. There is much more to learn, however.

Ms. Stewart trusts participation in this program will facilitate her patients’ wellbeing in receiving the best treatment possible, especially upon being discharged back to the community which includes Everett and the outerlying rural areas.