Benjamin Stephens, MD is a 2021 graduate from the University of Virginia General Psychiatry Residency now in private practice in the Charlottesville, Virginia area.  He spends most of his time in direct patient care and hopes to form relationships with local primary care providers to establish his own collaborative care practice.  Dr. Stephens clinical experiences with behavioral health integration in primary care and rural telemedicine to underserved areas of Virginia has driven his interest in the collaborative care model.  He hopes to deliver higher quality care, at lower cost, to more Virginians who need mental health services.  By participating in the Community Based Fellowship Dr. Stephens hopes to bring the best practices in collaborative care back to Central Virginia.  In 5 years he hopes to have his own collaborative care practice and see collaborative care become more common in psychiatry residency training programs in Virginia.

Bianca Reis, DNP, ARNP, PMHNP-BC graduated from the Doctor of Nurse Practice program at the University of Washington in 2020 and has since worked as an outpatient Psychiatric Nurse Practitioner at a Community Health Center treating children through adults. Prior to this, Dr. Reis worked as a Psychiatric Clinical Nurse Specialist at UW-Valley Medical Center, overseeing the treatment of patients on the medical floors hospitalized with a primary or secondary, co-occurring psychiatric condition.

Dr. Reis would like to bring the extraordinary multidisciplinary and collaborative care work and effort she has experienced in the acute care setting to the outpatient setting. Although the collaborative care model is growing in community health, there continues to be systemic barriers to its progress and success. Dr. Reis hopes that this program will provide the tools to address the obstacles so that collaborative and integrated care models can grow and thrive.

Five years from now, she hopes that most of the current barriers to meaningful collaborative/integrated care models are eliminated so that care team members communicate effectively to bring about improved outcomes in our communities. 

MaryAnne Murray, DNP, EdD, FNP-BC, PMHNP-BC, CARN-AP has lived in Western Washington since she was a small child. Twenty years ago she left the big city and has lived in a series of rural communities. When she landed on the Long Beach Peninsula eight years ago, she found her place of joy. She is self-employed in a small private practice, plus she contract her services to a residential substance use disorder treatment program where she performs a psychiatric evaluation and medication management for each client. She also does some teaching, including precepting PMHNP students.

She has undergone training in MindBody Medicine and believes that health care needs to address the needs of the whole person. Integrated care is one way to accomplish this, and this fellowship offers a model which can work effectively while leveraging the skills of a psychiatric prescriber as a consultant to assist primary care providers in helping patients achieve their goals. She hopes to do this for her hometown and other communities in her rural county. She hopes to collaborate with two primary care physicians and a cast of ancillary-skilled individuals to create an integrated care clinic which likely will serve individuals from their town as well as 0communities up to 50 miles away.

In 2026, she expects that integrative care will be the model that people demand. She predicts that unless a person has a longstanding relationship with a particular primary care provider, he or she will reject primary care options which fail to include the whole-person focus. By that time, the other primary care clinics in her rural county will have adopted our model, or ask her or her team to show them how they have accomplished it. She hopes that by 2026, her team will be able to provide this care in a cost-effective manner with appropriate reimbursement which will allow them to pay their team reasonably well, offer the best healthcare place to work, and provide the most comprehensive healthcare services in the county.

Anna Raymaker, DNP, ARNP, PMHNP-BC provides psychiatric services at Columbia Valley Community Health (CVCH), a Federally Qualified Health Center (FQHC), in Chelan, WA. This is the first time that CVCH Chelan has had a psychiatric prescriber on site full-time. Dr. Anna Raymaker provides both ongoing psychiatric treatment to a panel of patients as well as consultative services to the primary care providers (PCPs) at CVCH Chelan.

Dr. Anna Raymaker has worked in healthcare for approximately 10 years, and has explored various settings, specialties, and geographic locations throughout her career. She feels fortunate to have a meandering and nonlinear career, as it has provided her with so many unique and rewarding learning experiences.

CVCH Chelan utilizes an integrated care model, where medical, dental, and behavioral health services are provided under the same roof and in a collaborative way. Dr. Anna Raymaker is new to this model and hopes to further develop the communication and clinical skills necessary for this model of care through the UW Community-Based Integrated Care Fellowship.

Dr. Anna Raymaker hopes that involvement with the UW Community-Based Integrated Care Fellowship will allow her to help facilitate growth of behavioral health services within her agency and her community. For the near future, Dr. Anna Raymaker hopes that integrated care becomes a possible model for all rural communities, as rural healthcare continues have unmet primary care and behavioral health needs. 

Sahciko Oshio, PhD has a private practice mainly focused on women’s care for Japanese speaking women. She has been providing midwifery and women’s healthcare in various settings (private obstetrician’s office, my own private clinic, and hospital-based midwifery practices) in the past 20 years and recently added mental healthcare to the same population. Her main interest is women’s reproductive mental healthcare.

She is a novice as a mental healthcare provider. She hopes to learn from the leaders and fellow participants the arts of mental healthcare. She would like to develop a network of resources she can turn to and send patients to as appropriate for their needs, and in turn, she would like to be a resource for Puget Sound area women’s healthcare providers and birth communities.

Psychiatric mental healthcare can be more effective when paired with the content-specific expertise of specialists in various settings. For example, she is intimately familiar with experiences of infertility treatments, miscarriages and still births. She has supported patients through traumatic birth experiences and knows the reality of having a challenging newborn infant at home. By adding collaborative care provision skills, she can support perinatal/women’s healthcare providers with stronger mental health component.

Mental healthcare will become routine component for midwives and women’s healthcare providers.

Danielle Waldron, MSN, ARNP is entering her eighth year as a psychiatric nurse practitioner. She works both at Behavioral Health Urgent Care (BHUC) and in a small private practice in Snohomish County. In her clinical work at the BHUC, she assesses patients in crisis and assists those with difficulties accessing psychiatric care in their community. She provides psychiatric evaluation as well as consultation with ER physicians, primary care providers, and case managers, with the goal of assisting with ongoing care recommendations. She encounters a wide range of psychiatric disorders in this setting. In her work in private practice, she provides ongoing medication management and supportive therapy.

While she has some experience collaborating with primary care providers in her current work, she would like to improve her knowledge and skill set through the UW Community Based Integrated Care Fellowship. She is particularly interested in improving care around perinatal mental health and substance use disorders in integrated models. These patients are often seen as too complex for integrated care; however, they often have no other options for care. Her participation in this program will improve how she is able to advocate for integrated care for patient populations who are underserved.

In five years from now she hopes to see Collaborative Care expanded to reach more patients in need of psychiatric care in a timely manner.

Angela Hamel, ARNP, PMHNP-BC will be starting her 3rd year serving patients of all ages at Kadlec Behavioral Health Clinic. She is also working at Washington State University as an adjunct professor teaching nurse practitioner students specializing in psychiatry. Prior to becoming a nurse practitioner she was an acute care nurse for over five years.

Mrs. Hamel received her Master’s degree at Gonzaga University. She is currently completing her Doctorate in nursing practice at Chatham University. Mrs. Hamel is a Center of Excellence, meaning she has been trained to diagnose and refer clients with Autistic Spectrum Disorders (ASD) to Applied behavioral analysis (ABA). She has also achieved her Medication Assisted Intervention (MAT) waiver for the purposes of opioid use disorder treatment.

Mrs. Hamel has been collaborating with primary care providers in her current organization by making recommendations for patients with mild to moderate symptoms of mental illness. She is hoping to improve this program by participating in the UW Community-Based Integrated Care Fellowship. She is particularly interested in utilizing collaborative care to reach more individuals with mental illness and learn how to incorporate telepsychiatry into her practice to help patients in underserved areas.

Leslie Hite, ARNP, PMHNP-BC is a Psychiatric Mental Health Nurse Practitioner at Mid-Valley Clinic, a rural health clinic in Omak, WA (Okanogan County). She provides mental healthcare services for individuals across the lifespan and works collaboratively with primary care providers, specialty healthcare providers, chronic care managers, and community support services to provide a “team-based” approach to health. Ms. Hite also takes referrals from healthcare providers all over Okanogan County to meet the mental health needs of Okanogan County.   

Ms. Hite is interested in collaborative and integrated healthcare because she believes that a “team-based” approach has always been the best healthcare approach. She enjoys working together with an individual’s primary care provider and including other specialty providers and community resources to provide the best opportunity for health and wellbeing. Through this fellowship, she hopes to gain knowledge, new resources, and new ideas in providing integrated healthcare. 

Ms. Hite chose to pursue this fellowship to develop knowledge and skill in providing integrated healthcare that she plans to share with the healthcare providers and staff that she works together with which will increase the health of individuals across the clinic, community, and county.

In 5 years, she hopes to see that all healthcare providers are practicing collaborative or integrated healthcare everywhere. In Okanogan County, she hopes to see a positive trend in healthcare statistics or community health scores because of practicing integrated healthcare. 

Po Karczewski, ARNP is a contract prescriber, Psychiatric ARNP, currently providing medication management, assessment, and motivational interviewing for an inpatient drug and alcohol treatment facility, a child and adolescent clinic which has not offered medication management previously, and a clinic serving HIV positive clients.  He has always been an advocate for the importance of therapy, good nutrition, physical health, healing environments and psychiatric medication being used in conjunction with each other, along with emphasizing the cautious and judicious use of psychiatric medication. 

Mr. Karczewski hopes to develop a better understanding of how to be an effective voice for integrated care in his community in Pierce County, and to be able to work with the other Fellowship graduates in his area. Some efforts in this area in the past have resulted in sub-standard care, and it is important to have an effective model for integration.

He hopes to see Collaborative Care/integrated care be the standard of practice/organization. He thinks that the sharing of information systems with rigorous history and current status charting is likely to be more effective than attempts at partial co-location of services.

Katherine Kirner, ARNP has worked as a primary care provider at a Federally Qualified Health Center in Twisp, WA for the past 12 years. At least an hour from the nearest hospital or referral center, there is a mixture of  primary and emergent/crisis care. Frustrated by the lack of psychiatric resources in the area, she returned to school for certification as a PMHNP a few years ago. Now, she is also working as a psychiatric nurse practitioner at a small private practice. She continues to use her behavioral health expertise within the confines of a traditional primary care appointment.  

By participating in the Community-Based Integrated Care Fellowship Ms. Kirner looks forward to exploring ways to bring those two worlds together. As her organization moves toward integration of behavioral health and primary care, they are challenged by the geographic isolation of each of their clinics and lack of qualified providers. Ms. Kirner hopes to learn about telehealth and other strategies to provide resources for both patients and clinicians, even in the most remote clinics.

In the future, she would like to see behavioral health strategies used for all aspects of health care – from traditional mental health issues to diabetes and IBS. She is encouraged by the efforts of the University of Washington and other organizations to increase accessibility but acknowledges that there is still significant stigma and resistance on the part of patients. She believes that, through integrated care, we can continue to break down those barriers and normalize the experience of seeking help.