But for every leader we've spoken to who uses LCSWs to the top of their license, there is another who's uncertain about how and why to incorporate them into the care team. Here are the main benefits and challenges of incorporating the LCSW into primary care.
LCSWs optimally support complex patients with behavioral health and psychosocial needs
The LCSW is a versatile, low-cost, revenue-generating team member, able to support complex high- and rising-risk patients. We typically see the LCSW deployed in primary care in either a behavioral health or a care management capacity.
LCSWs acting as behavioral health specialists perform screenings, collaborate with primary care physicians to inform patient care plans, and support patients through short-term therapy and referring them to social services in the community.
LCSW care managers function similarly to RN care managers. They actively identify and address unmet social needs, coordinate care services, and support patient adherence to care plans to drive self-management. Where they differ is in training: LCSWs are trained to provide behavioral health and social service support, making them a better fit for complex patients with behavioral health and psychosocial needs when compared with the RN care manager.
Poor role definition threatens top-of-license care; poorly-studied ROI threatens likelihood of investment
Leaders often fail to effectively define the LCSW role and communicate it to the care team, which puts LCSWs at risk of being tasked with responsibilities that fall outside of their job description. For example, care teams may use them as practice-wide community resource navigators rather than care managers dedicated to high-risk patients. In that case, they're not working at top-of-license. Take advantage of team huddles or regular primary care meetings to clearly communicate the LCSW's role in order to mitigate this risk.
Additionally, there is minimal research that looks specifically at the impact of the primary care-based LCSW. This dearth of information can make it difficult for primary care leaders to make an effective case to their executive teams for budget dollars. While the growing prevalence of LCSW in primary care may encourage future studies, for the time being you can look to the ROI of LCSW-delivered services to estimate their ROI, absent organization-specific information. Integrated behavioral health and high-risk care management each have proven ROI.