Naomi Wenzel, ARNP, MEd

Naomi Wenzel ARNP, M.Ed. says that her early life experiences of living in orphanages in South America within the Hispanic culture has been pivotal in the work that she has chosen to do as she reaches the mid to latter portion of her working career.

Twenty two years ago, she was invited by the Sisters of Providence (Providence Health care system in Seattle) to join them in caring for the migrant Hispanic families in Yakima. After assessing the needs of the community and designing tools to measure outcomes, Ms. Wenzel worked out of a medical van where she traveled to apples fields, community centers or churches to help families access care. She says part of the greater challenge was that once they assessed the need (through screening) particularly for mental health, there were no affordable resources available for our families to follow through with treatment. As a way to meet the need, Ms. Wenzel started to volunteer at the local free clinic.

Ms. Wenzel currently works with Comprehensive Health Care in the inpatient adolescent E and T facility (she also previously worked with outpatient adults and children), where she assesses and stabilizes youth with suicidal, homicidal ideation or who are gravely impaired. At the Unit, she treats previously undiagnosed mental illness, current mental illness and help youth learn healthy ways to respond to distress prior to their discharge home, if the home is a safe environment.

Ms. Wenzel’s other work involves consulting with a Chemical Dependency inpatient facility in which many of the clients have not been diagnosed or recently treated for their mental illness, and helping with prescribing medications during the withdrawal phase of their chemical dependency treatment.

Lastly, Ms. Wenzel volunteers at the Free Clinic as the mental health provider and hold support groups at the clinic or at local churches.

Ms. Wenzel’s main interest in Collaborative Care is to assist the underserved populations in Yakima that work in the agricultural industry who typically are not insured. She has found however, that not having access to additional help in Behavioral Health or in Chemical Dependency is a challenge. She is hoping that going through the Fellowship program will give her the expert panel she needs to formulate her idea into a practical and innovative way of dealing with mental illness/chemical dependency in multiple settings and populations, not just the underserved.

Thanks to today’s technology and how easily it has become to connect with different systems, Ms. Wenzel’s hope is that people feel less isolated, and have less and less of a challenge in collaborating with different specialties and truly begin to have an integrated medical system that can offer comprehensive and cost effective ways of doing wellness, and preventing costly consequences of “no care” or inadequate care.

Angela Argyropoulos, MD

Angela Argyropoulos, MD, obtained her medical degree at the University of Michigan Medical School, and did her residency at the University of Washington. During her residency training, was first drawn to integrated care during a rotation in which she worked in a mental health clinic co-located within a primary care clinic. She particularly enjoyed collaborating with the clinical team, including the primary care physicians and psychologists, as well as teaching within this role. She later chose to do a BHIP rotation and has enjoyed reaching a broad range of individuals in need of mental health care through the collaborative care model.

Dr. Argyropoulos also particularly enjoys psychotherapy and feels that working as a psychiatric consultant is an excellent complement to psychotherapy work, as this role provides a way to serve a larger number of patients in the greater community while continuing to work in a team.

Dr. Argyropoulos believes that increasing access to psychiatric care and taking a team-based, interdisciplinary approach in supporting our primary care colleagues in providing mental health treatment are particularly meaningful aspects of her work. She is hopeful that collaborative care will continue to grow throughout the country and improve availability of mental health services to those most in need.

Amber Kostial, MD

Amber Kostial, MD, has been running a private adult general psychiatry practice in Bellingham since 2016. She opened her practice after working for a year at the local hospital due to observing the need for increased outpatient psychiatric care in the community. She owns her own practice, but shares office space and participates in an office association with two other psychiatrists and 6 psychotherapists, which allows for a community feeling and ample opportunity for consultation and collaboration.

Dr. Kostial’s interest in collaborative care was sparked by her experience participating in integrated care as a psychiatric consultant for PeaceHealth primary care clinics in Bellingham and via telemedicine with Peace Island Medical Center on San Juan Island. She enjoyed being able to collaborate with primary care providers and behavioral health care managers to help optimize mental healthcare for individuals in a timely and efficient way and to help identify individuals in need of more intensive care with a psychiatric prescriber and/or psychotherapist.

Dr. Kostial gained a basic understanding of integrated care systems through her experience and readings at the time, but through participating in the Integrated Care Fellowship she hopes to gain a breadth and depth of knowledge that will allow her to offer psychiatric consultation services to her community in an optimally informed, effective, and evidence-based way. There is a major shortage of psychiatric prescribers in Whatcom County, with no outpatient psychiatric services offered through the hospital, only a couple community mental health agencies serving individuals with Medicaid, and a handful of private practice psychiatrists/ psychiatric prescribers, with only a couple who take Medicare.

By participating in the Integrated Care Fellowship, Dr. Kostial hopes to help expand the reach of behavioral health care to individuals, including those who may never see a psychiatrist or therapist, in her local community. She hopes to share her experience with other local psychiatrists/psychiatric prescribers to get them interested in participating in integrated care also.

Dr. Kostial hopes that integrated care will be a usual component of primary care within the next 5 years. She also wonders if there might be value in the longer term to extending to some nonprimary care settings (e.g. neurology, dermatology, pain clinics, surgery clinics) to reach patients with frequent specialist contacts and complex comorbidities that may be significantly impacted by/have significant impacts on behavioral health.

Daniel Ferber, MD

Daniel Ferber, MD, does clinical work that includes psychiatric assessment and medication management to patients across the age spectrum. An interdisciplinary approach to patient care is integral to his role as a medical provider working in community mental health.

Dr. Ferber’s interest in participating in the collaborative care fellowship evolved from his role as Medical Director of a Community Mental Health Center currently in the process of implementing a Coordinated Care Behavioral Health Center (CCBHC) grant. He hopes that the knowledge gained from his participation in the fellowship will allow him to be a more effective participant in clinical planning at the agencies where he practices.

Dr. Ferber believesthe relationships developed from his participation in the fellowship will continue to be an invaluable resource as the application of integrated care evolves and impacts his clinical practice.

Over the next five years , Dr. Ferber envisions coordinated care/integrated care as contributing greatly to improved health outcomes for our patients. Hopefully, the coordination between physical and mental health providers will not be implemented in such a way that it is perceived as an additional burden on our medical providers.