Integrated Care in Specialty Clinics

This CFHA Podcast episode features integrated behavioral health clinicians working in specialty settings: Dr. Kim Smolderen (integrated psychology in cardiovascular care at Yale Heart and Vascular Center), Dr. Jonathan Deiches (psychologist in bariatric surgery and a diabetes/obesity clinic at WVU Medicine), and Dr. Toni Mahold (integrated behavioral health in a Minnesota Heart and Vascular Center with inpatient and outpatient continuity). They describe common referrals (post–heart attack depression, stress cardiomyopathy with trauma, device-related PTSD, postpartum hypertension stress management, bariatric pre-surgical evaluations, depression affecting diabetes care, eating disorders, and picky eating), the importance of co-location, warm handoffs, and team-based routines, and how credibility grows through relationships and demonstrated patient impact. They discuss applying PCBH concepts like GATHER to specialty care, the need for space, leadership buy-in, and metrics beyond RVUs, and future goals including playbooks across specialties, broader training, reduced stigma, sustainability, and leadership in system design.