How to Partner with Our Psychiatry Team – Cont’d

Many AWARE clients may benefit from Psychiatry Services.  In this month’s article, I’ll explain how to get Psychiatry involved for your clients who may need our services.   

But first, an exciting announcement: AWARE has hired a new Psychiatric Nurse Practitioner to join our team!  Christian Madson, DNP, PMHNP, will be joining the Great Falls office in January 2025.  She will also be providing coverage to our Billings community.   This much-needed expansion enables us to address the rising demand for psychiatric services, ensuring improved access for those who may benefit from our care. When you get a chance, please introduce yourself to Christian in January.  We think you’ll find her just as kind, thoughtful, and community-focused as we did (do).   

Now, back to the regularly scheduled programming.   AWARE Psychiatry accepts referrals from both inside and outside of AWARE.  However, we prioritize internal referrals (e.g., clients already receiving other AWARE services), and your role is essential in connecting these clients with Psychiatry Services.  If you notice that a client is engaging in other services, but still struggling with mental health issues, they may be a good candidate for a Psychiatric evaluation and management.  Here are some signs that a Psychiatric evaluation might be worth recommending: 

• Depression, prolonged grief, hopelessness 

• Severe anxiety, avoidance of activities, panic 

• Post-traumatic symptoms including dissociation  

• Difficulty focusing or completing school or work assignments 

• Psychosis (like schizophrenia) 

• Severe mood swings 

• Autism or developmental disorders with irritability, aggression, or other mood issues 

• Obsessive-compulsive behaviors, hair-pulling, skin-picking 

• Problems with eating, toileting, or sleeping 

• Gender dysphoria (of note, we don’t provide hormonal therapies but can help with other things) 

• Impulse-control problems, aggression, explosive outbursts 

• Suicidal or homicidal thoughts or behaviors 

• And lots more…  

If you think someone might benefit from Psychiatry, reach out and ask any of our providers or medical director.   

Once you’ve identified that a client may benefit from Psychiatry, here’s how to refer them.  First, discuss it with the client or their guardian – they must consent to the referral.  Then, contact the local administrative assistant in your office and ask them to help you start the referral process.  The AA can work with you to obtain the paperwork needed.  After that part is done, the medical director will review the referral with the referral review team, to make sure we can adequately help the person in question.  We almost always accept these referrals, but if we have to deny someone, we will explain why and offer some alternatives.  Once the referral is accepted, our AA’s will work to get the client scheduled.  Of note, because psychiatry is a medical discipline, our team may refer to the client as a “patient.”  That’s it!  Sometimes this process takes a little time, but it’s pretty easy.   

After the Psychiatrist (Dr. Brogan) or Psychiatric Nurse Practitioner (Jill, Katy, Susan, or Christian) has started working with the patient, we will work with the other service lines to coordinate our treatment plan.  We interface very closely with our other service lines.  In each community, the Psychiatric Nurse Practitioner should be able to join FACT Staffing meetings about once a month.  Additionally, treatment team meetings can be arranged for more complex situations.  The medications we prescribe can be helpful, but we rely heavily on the rest of the care team to help patients learn and grow.  “It takes a team,” after all.