Care teams often need help with behavioral management, yet it can be challenging to get residents out to see specialists or to bring psychiatrists or psychologists into the facility. To address this, Santos and her team developed a behavioral health program with four components: on-site psychiatric nurse support, telepsychiatry, telepsychotherapy, and telementoring.

Adam Simning, MD, PhD, assistant professor in the department of psychiatry and public health sciences at the University of Rochester, said, “It’s critical to have the reach we do, as there are many people with severe, persistent mental illness in nursing homes. These individuals have complex psychiatric needs that require professional intervention. For people with mood or psychiatric or personality disorders, psychotherapy is critical.”

The interventions start with the on-site visit from a psychiatric nurse who addresses issues such as behavioral health access, care continuity, and staff education. These practitioners then make monthly visits, teach nonpharmacologic management to staff, and proactively review behavioral needs of residents and referrals to telepsychiatry. Then, in addition to the telehealth visits, telementoring efforts provide biweekly grand rounds for providers and staff, lectures on best practices, and resident case discussions with an expert panel.

“It helps staff to have behavioral health experts and champions to weigh in on complex patients. We also have experienced nurses to help develop behavioral care plans,” said Simning. He said this team approach to managing behaviors, with the involvement of practitioners that facilities might not normally have access to, can enable quality outcomes for residents. It also strengthens the facility’s behavior management program and gives staff the tools and skills they need to be consistently effective. ​