Integrated Care/Healthy Together

Acute Care Services
can be reached 24/7
603-434-1577 Option 1

Brings a whole-health approach and one-stop convenience to your mental and primary health care.

Integrated Care provides whole-person, wrap-around healthcare through services centered around mind-body wellness, enhancing quality of life, and chronic disease prevention and maintenance. We are focused on working with you to address both your physical and mental health care needs.

Individuals with serious mental illness often fall behind in receiving proper care for generally preventable medical conditions such as heart disease, obesity, diabetes, and other chronic diseases. Although these diseases can affect anyone, people with serious mental illness are disproportionately impacted leading to poorer quality health outcomes and shortened life expectancy. Integrated Care aims to reverse that trend and improve the health-related quality of life and overall well-being of those receiving care.

All Integrated Care services are open to state eligible adults, while Healthy Together services are open to any individuals ages 12+ regardless of the ability to pay. Any eligible adult individual with physical health conditions that impact daily functioning could benefit from the various supportive services provided by Integrated Care.

Healthy Together, through a partnership between CLM and Lamprey Health Care, provides high quality primary care services to individuals age 12 and older. Primary medical care is an important component to overall health. Healthy Together provides a one-stop solution for whole-person care by giving patients the convenience of primary care in the same setting as their mental health care. Our Primary Care providers are a part of our Integrated Care team, leading to full wrap-around care with increased collaboration and communication between your mental health and medical care providers. Our Healthy Together primary care clinic is located at the CLM Derry office. Download Healthy Together flyer

Healthy Together Primary Care

Individual – Our initial goal of therapy starts with building trust so that we can communicate in a safe setting and form a healing partnership. Through this partnership we can assist you with overcoming obstacles, inspire change, and improve quality of life. We can assist in learning skills for handling difficulty situation, making healthy decisions, and reaching your goals.

Group – Group therapy offers individuals a safe and comfortable place where they can process emotional issues, gain insight into their own thoughts and behaviors, and offer suggestions and support to others. In addition, individuals who have a difficult time with interpersonal relationships can benefit from the social interactions that are a basic part of the group therapy experience.

Individual Adult Therapy

CLM offers a caring team of medical specialists in psychopharmacology (specific medication for behavioral health).  Our team utilizes a biological model of prescribing appropriate psychiatric medications when indicated and will adjust as needed to help reduce symptoms, increase comfort or heighten the effectiveness of the comprehensive counseling services at CLM.

Our Medication Services are provided by Board Certified Psychiatrists, Advanced Registered Nurse Practitioners, and Nurses under the supervision of our Medical Director.

CLM understands that all medical issues require comprehensive treatments that may include biological, psychological and sociological interventions.  Our team of medication providers work in partnership with the rest of your treatment team to ensure coordination of care. Psychiatric services include psychiatric evaluation, consultation with your CLM clinician and treatment team to ensure comprehensive and well-coordinated care, and ongoing management whenever possible with your primary care provider to ensure integration between your mental health and medical care.

Healthy Together Primary Care

Integrated Care Case Management (ICCM) provides care planning, resource identification, benefit coordination, service monitoring, internal and external care coordination with Choices for Independence (Long-term Medicaid) and their vendors, and community-based counseling support to assist clients with improving symptoms and behaviors that otherwise interfere with daily functioning and wellness goals. ICCM is for clients with high physical health needs that require extra care coordination with external providers.

Functional Support Services (FSS) are face-to-face clinical interventions provided in the individual’s home or community. These services are designed to enhance resiliency, recovery, and integration in the community. There are four distinct Functional Support Services: Crisis Support Services, Family Support Services, Medication Support Services, and Therapeutic Behavioral Supports.

The goal of FSS is to assist clients and their family members navigate through the complexities around mental illness. We set goals with the client towards regaining control over their lives and achieving their personal goals. FSS provides education and skill development in areas including acute crisis management, maintaining a medication treatment regimen, family support and education, individualized resiliency training, and pursuit of employment and educational goals.

The goal of Community Support for Medical Needs is to problem-solve, develop strategies, and reinforce skills to reduce mental health symptoms and behaviors that hinder a client’s success with caring for their physical health. Clients work with the Community Support provider to increase their follow through with attending necessary primary care and specialist appointments, self-advocating in the medical setting, managing mental health symptoms, and completing tasks/next steps ordered by medical providers (i.e. completing bloodwork, obtaining ultrasounds or x-ray, contacting new specialty referrals).

Behavioral Health Visiting Nurse (BHVN) services are community-based Functional Support Services provided by a qualified nurse to improve the whole health of clients by addressing all mental health barriers that impact a client’s ability to care for their physical health. All clients in Integrated Care are followed by a BHVN and receive a thorough nursing assessment to identify their areas of need. This service includes tasks such as taking vitals regularly and communicating results with medical providers, education on chronic disease self-management, medication training and support, and internal and external care coordination to improve the whole health of the client. MTS is integrated within this service to provide the education, guidance, and care necessary to support clients with understanding and continuing their medication regimen. MTS can support with self-management of filling medication planners, transition to bubble packs, psychoeducation on medication, documenting and addressing side effects, problem-solving barriers, developing creative solutions for medication adherence, and managing medication refills.

Integrated Illness Management and Recovery (I-IMR) was developed in response to the high rates of medical comorbidity in people who have a serious mental illness. The purpose of the program is to empower consumers with knowledge and skills to better manage their health so that they can work on meaningful life goals. The approach and curriculum are modeled after the traditional Illness Management and Recovery Program. At the start of the program, the concept of recovery is introduced and consumers start to explore personally meaningful goals to work on during the program. Those goals are the foundation of the program and where motivation may be harnessed to improve self-management of mental and physical health.

NEW You (Nutrition, Exercise and Wellness) services supports individuals with making important lifestyle changes that support a reduced risk of obesity, diabetes, and cardiovascular diseases, while improving mental health symptoms, quality of life and longevity. This program embodies a whole new meaning of holistic health by incorporating a wide range of wellness services that expand beyond ordinary physical health maintenance. NEW You targets chronic disease prevention by providing a wide variety of wellness services tailored to the client’s individualized personal health and wellness goals. Clients are encouraged to be leaders of their own wellness journey. NEW You Wellness Coaches support clients with creating realistic goals, identifying possible barriers and plans to overcome them, and brainstorming the necessary steps to achieve goals. Wellness Coaches and their clients work together to ensure each client has the tools, education, and drive to work towards personal growth both with their coach and on their own. Wellness Coaches help guide the client’s journey of health, wellness and self-exploration leading to more meaningful and healthy lives.

New You and nutrition