The Power Of Collaborative Care Intervention: Support For Marginalized Demographics

Collaborative care, a term for a team of healthcare providers offering multiple physical and mental health services simultaneously, has been a focus of recent studies. New research has found promising results in collaborative care as a treatment approach for marginalized people experiencing post-traumatic stress disorder (PTSD). Those looking for a trauma-informed approach to care that considers their unique identities may benefit from seeking collaborative care and exploring this research in more detail.

What is collaborative care?

The American Psychiatric Association defines the collaborative care model as a way for clients to receive integrated care from a team of healthcare providers that considers their unique needs based on identity and life experience. 

In this model, a client typically works with a primary care provider, behavioral health case manager, psychiatric consultant, and other providers as part of a treatment team. Often, all team members communicate with each other about their care plan (with the client’s legal consent), centering on the individual’s medical history and needs. The providers generally use evidence-based and up-to-date treatment protocols to ensure the client receives the highest quality of care. 

A collaborative approach generally aims to ensure all of an individual’s providers are on the same page and can work together to develop solutions. When a person has multiple providers from separate teams, miscommunications can arise, and providers might offer advice that is contradictory to other advice the patient has received. 

When all providers work together and are informed about the client’s experiences, they can tailor their approach around the care the individual is already receiving and discuss areas for growth with each other, reducing bias and the chances of missing important information. 

Post-traumatic stress disorder (PTSD) and collaborative treatment 

Post-traumatic stress disorder is often treated with a collaborative approach. Previous studies have found that collaborative care can be highly effective in supporting people with PTSD. In a 2021 study, researchers looked at a trial of 635 patients with traumatic injuries who were displaying PTSD symptoms. 

Those who were treated by a collaborative care team typically experienced significant symptom reduction after six months of treatment. Since PTSD tends to be more commonly diagnosed in marginalized groups, collaborative treatment approaches may be especially helpful for these communities.  

Symptoms of PTSD 

Knowing how PTSD can present may be helpful when considering the treatment approach that best suits you. Below are some of the symptoms of PTSD listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5): 

• Avoidance of people, places, items, topics, and scenarios that remind one of a traumatic event 
• Extreme emotional distress, mood swings, and fear 
• Repeated, distressing memories or nightmares of a traumatic event 
• Social withdrawal and isolation
• Hypervigilance or hyperfocus on sensory stimuli and one’s environment, often accompanied by fear 
• Shame and guilt 
• Difficulty forming healthy relationships 
• Physical symptoms like headaches, shakiness, or stomach pain

How to build a helpful health team 

Doctors, therapists, and other providers can work together to provide effective care by taking a collaborative approach. Often, effective collaborative teams have the following qualities: 

• Connected
• Trauma-informed
• Open-minded
• Educated
• Unbiased 
• Respectful 
• Inclusive
• Communicative
• Compassionate 
• Empathetic
• Individualized
• Intersectional 

Individuals can find collaborative providers by looking for healthcare teams or signing release forms for their providers to work together. Ask each provider whether they’d be open to collaborating with others on your care team. For example, you might sign a release for your therapist to be able to speak to your psychiatrist and doctor about your medical treatment and diagnoses.

Demographics that frequently face barriers to healthcare

Recent 2024 research has looked at how collaborative care can be particularly helpful for racial and ethnic groups experiencing PTSD and other mental health challenges. Exploring this new research and learning how this type of care can support marginalized communities may help you determine which type of treatment is best for you. 

How collaborative mental healthcare can support people of color 

In the above study from 2024, researchers looked at over 350 patients with PTSD who identified as Hispanic or non-White and 285 people who identified as White. 

Randomized participants from both groups were given either enhanced usual care or stepped collaborative care with case management, cognitive behavioral therapy (CBT), and medication. 

They found that those who identified as Hispanic or non-White and received collaborative care typically experienced significantly lower PTSD symptoms compared to Hispanic or non-White individuals who received usual care. 

No differences were found between the two groups who identified as White. This research suggests that collaborative care may be significantly impactful for those with racial and ethnic minority statuses. The researchers concluded these benefits could be due to the patient-centered focus, flexibility, and emphasis on shared decision-making. 

Evidence-based collaborative care for the LGBTQIA+ community

Integrative care, another term for collaborative approaches, may be especially effective for those who identify as LGBTQIA+. Because those in this community tend to have a higher risk of mental health disorders and suicide, having multiple treatment providers available for care can lead to an unbiased, patient-centered treatment process. 

In addition, integrative care might be helpful for those who identify as transgender or non-binary and are looking for physical and mental healthcare options as they transition or pursue gender-affirming care. 

Collaborative health care for immigrants, refugees, and cultural minorities 

Immigrants, refugees, and cultural minorities often face discrimination and unique barriers to mental health care. Having a team of providers can improve communication, reduce the chances of bias, and help these individuals receive more comprehensive support. In addition, translation options may be available with a team approach, ensuring these individuals can adequately communicate their needs and receive accurate information. 

How collaborative primary care can be helpful for Indigenous and tribal communities 

A 2022 study examined how providers integrating Indigenous healing practices into collaborative care teams could help those in tribal and Indigenous communities and families. They found that Indigenous leadership was often included in these healthcare decisions and frequently improved the mental and physical health of communities overall, citing community engagement, elder support, and tradition. Including one’s spiritual and cultural needs in collaborative care may be a helpful approach for marginalized individuals. 

Trauma risk and the importance of trauma-informed primary care for marginalized groups

When looking at why collaborative approaches may be beneficial to marginalized communities, such as ethnic and racial minorities, understanding cultural and identity-based trauma may be helpful. People with marginalized identities are often at a higher risk of various forms of oppression, such as racism, xenophobia, and homophobia. 

Hate crimes, bullying, and oppression can all constitute forms of trauma and may lead to the development of PTSD in some people, even if they do not for everyone. Since marginalized communities can also experience a higher risk of income disparity, housing discrimination, and assault, trauma is often more commonly reported in these communities. At the same time, a lack of access to quality healthcare can lead to worsened mental health outcomes, as people struggle to find adequate support or understand they could benefit from help due to stigma and fear. 

For these reasons, it can be especially important for marginalized groups to have access to trauma-informed care, which may play a part in collaborative care.

Why does collaborative care help? 

When a person receives care from a single provider or from separate providers who are not in communication, there may be a risk of miscommunication, contradictory treatments, or a lack of understanding of the “big picture” in clinical outcomes. 

A team of providers can communicate with each other, filling the gaps that might otherwise be left empty and reducing the chances of medical errors. In addition, all aspects of the client’s health can be considered in one approach instead of only taking pieces of a patient’s history and ignoring the rest. 

A collaborative approach can be a cheaper, faster, and more effective way to ensure a client receives the care they require within a few appointments instead of seeking multiple opinions for multiple issues. Studies suggest that a collaborative approach can be more effective, efficient, and cost-effective, particularly in mental health care. 

Where to find a collaborative team 

When looking for collaborative care, you might consider the following: 

• Mental health community centers that provide psychiatry, case management, and therapy under the same roof
• Community health centers that provide medical care and behavioral health services in a primary care setting 
• Providers and mental health specialists that list themselves as integrative and collaborative on their website and are willing to sign a release to work with other providers
• Collaborative healthcare centers with primary care settings 

You can also talk to a social worker at an emergency room about finding a healthcare team in your area. In the United States, the 211 hotline can provide local healthcare and mental health resources. 

Finding a trauma-informed therapist for evidence-based mental healthcare treatment 

If you’re looking to add a trauma-informed therapist to your healthcare team for trauma or depressive symptoms, barriers might arise in finding a provider in your area. Having an online therapist through a platform like BetterHelp may be more accessible, allowing you to meet with your provider on your schedule and around other appointments, including outside of standard business hours. Online platforms allow you to match with a therapist who fits your unique situation, providing tailored and patient-centered care. 

Online therapy may effectively treat PTSD. According to a 2022 study, trauma-focused cognitive behavioral therapy appears to be just as effective when delivered online as it is in person.

Takeaway 

New research has found that a collaborative care approach can be beneficial for clients with PTSD, especially those within marginalized communities. Racial and ethnic minorities, LGBTQIA+ people, gender minorities, immigrants, and Indigenous communities may all benefit from an integrative approach to mental health and physical treatment. However, anyone can use integrative care, which appears to be becoming more common worldwide. If you’re living with PTSD or another mental health concern, reach out to a therapist locally or through an online therapy platform.