This behavioral health prescription specialist is a psychiatrist, psychiatric nurse practitioner or prescribing psychologist called the external behavioral health consultant (EBHC). The DoDI 6490.15 “Integration of Behavioral Health Personnel (BHP) Services Into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings” describes the Behavioral Health Care Facilitator (BHCF) Service Delivery Model which describes the collaboration and team consultation among the primary care manager (PCM), internal behavioral health consultant (IBHC), and a behavioral health prescription specialist.
The Role of the EBHC
The EBHC’s primary responsibility is to enhance the PCM’s management of psychoactive medications by providing verbal and/or written consultation on initial medication decisions, changing medications and managing side effects. The EBHC is also available to advise the PCM regarding work-ups of neuro-psychiatric symptoms (e.g., need for neuro-imaging, lab testing, EEG, etc.); ongoing management of psychotropic medications (e.g., drug-level monitoring, chemistry/complete blood count (CBC)/urine testing, etc.); and need for referral to specialty mental health care. Upon request, the EBHC may also consult with the IBHC regarding behavioral health cases. The EBHC is not co-located in the medical home and does not evaluate patients in person, but rather provides only consultative services to primary care.
Not all clinics utilize the services of an EBHC. PCMs can contact the IBHC or BHCF in their clinic to determine whether there is an assigned EBHC and to obtain contact information. IBHCs or BHCFs can contact their service’s PCBH program lead for this information.