You are already managing their depression. Now you have a team for it.
Most primary care physicians carry the behavioral health load alone, with nowhere good to send people and no way to see whether anything worked. Integral Health puts a behavioral care manager and a consulting psychiatrist behind you, inside your practice, without adding a system or a hire.
The problem is rarely the diagnosis.
Physicians recognize depression and anxiety all the time. What they lack is somewhere to refer the patient, a way to know the referral worked, and the time to arrange it at the end of a visit already running over.
The psychiatry waitlist is months out, and the practices taking new patients are not taking their insurance.
The referral goes out and the loop never closes. You find out it failed at the next visit, if there is one.
The depression surfaces at the end of a fifteen-minute visit built for something else entirely.
There is no trend line for how someone's mood has moved since last spring, so treatment changes are a judgment call in the dark.
We go in and find the patients others miss.
This is not new volume to generate, and it is not a list somebody hands us. It is people you already see, whose behavioral health need is sitting unaddressed in their record. Nightingale reads the whole record and surfaces each gap.
Who does what, from flag to follow-up.
The honest version of the division of labor. Two steps sit with you. The rest is ours.
The patient is found
Nightingale sweeps the panel and flags who is deteriorating, with the reason attached. Nobody reviews charts by hand.
You see one flag
It appears in the chart you are already in. No second system, no new login.
We reach the patient
A behavioral care manager calls within about 48 hours, in the patient's own language, and keeps calling until they answer.
They are seen in days
First appointment inside your practice, not a waitlist at a clinic across town.
Treatment is tracked and adjusted
PHQ-9 and GAD-7 every visit. A consulting psychiatrist reviews the whole caseload weekly and advises on medication.
You get the answer back
The trend, the recommendation, and the note land in the chart. You stay the prescriber and stay in the loop.
They graduate, or we escalate
Patients exit with documentation and a follow-up plan. The ones who are not improving get changed, not closed.
What the care team works from.
You do not have to live in this. It is where your care manager finds the patients who are slipping, so the only thing that reaches you is the answer.
| Patient | Program | PHQ-9 | GAD-7 | Last contact | Status |
|---|---|---|---|---|---|
| Louise M. | CoCM | 14 → 8 | 11 → 6 | 2 days | Titrate |
| James O. | CoCM | 9 → 4 | 8 → 5 | 5 days | On target |
| Priya S. | BHI | 16 → 15 | 12 → 11 | 12 days | Follow up |
| Wei C. | CoCM | 12 → 5 | 9 → 4 | 3 days | On target |
| Dana R. | CoCM | 7 → 3 | 6 → 3 | 6 days | On target |
Before Integral Health, and after.
Year-one program outcomes across a partner population, from screening rates through to total cost of care.
What physicians ask first.
What actually changes in my day?
You read a flag in the chart, and later you read a note. Everything between those two moments is run by the care manager and the consulting psychiatrist.
Do I have to hire behavioral health staff?
No. The behavioral care managers and the consulting psychiatric capacity come with the program, which removes the recruiting and turnover problem entirely.
Do I lose control of the patient?
No. You remain the treating physician and the prescriber. The consulting psychiatrist advises you; they do not take the patient over.
Is this another system to log into?
No. Flags, notes, tasks and social needs are written into the chart you already work in. There is no parallel record to maintain.
How is this different from referring out?
A referral sends the patient somewhere else and usually loses them. This keeps treatment inside your practice, tracks whether it is working, and tells you when it is not.
What about patients who do not speak English?
Care managers work in the patient's own language, including Mandarin and Cantonese, so the follow-up calls actually land.