North Carolinians with oral health complications and potentially struggling to meet basic needs now have access to virtual services from UNC-Chapel Hill medical specialists and social workers. The telehealth services, provided by the UNC Adams School of Dentistry and the UNC School of Social Work, were launched following the closure of dental clinics on campus due to the COVID-19 pandemic.
The services ensure that all patients, especially those who are at higher risk for illnesses, continue to have access to an oral medicine doctor without having to leave the comfort of their own homes, said Jamie Burgess-Flowers, a social work clinical assistant professor and dentistry faculty member. Currently, clinic appointments are conducted via Zoom meetings twice a week.
The new initiative is part of a growing movement toward integrated health care, in which physicians and mental health professionals collaborate as a team to diagnose and treat patients. This model is the backbone of the School of Social Work’s UNC-PrimeCare program, which rigorously prepares students to work in primary care settings as behavioral and mental health care specialists.
The project is also the second recent collaboration between the two schools. This fall, they will jointly launch i-STEP, or Interprofessional Substance Use Disorder Education and Training, an initiative to help social work and dental health professional students learn more about substance use disorders.
As lead social worker on the oral medicine telehealth services project, Burgess-Flowers works closely with her team to help patients navigate service needs, such as access to housing and transportation options, as well as mental health and substance use counseling. These patients are often referred to a social worker after a team member assesses their general health history.
“As part of that health history, they are asked nine questions, such as ‘Over the past year, have you or anyone in your family had difficulty affording a phone, housing, or food?’” Burgess-Flowers explained. “If a patient says yes to any one of those things or screens positive for depression or anxiety, they are scheduled to meet with me.”
Patients who are referred are assessed more closely to ensure their full needs are understood. In some cases, Burgess-Flowers offers brief counseling services or, if needed, connects patients with mental health support within the community. She also manages care coordination, helping patients navigate other challenges, including financial issues.
“For example, this week we had a patient who is uninsured and needed a special mouthwash to manage her symptoms and couldn’t afford it,” she said. “So we talked to her about affordability options and applying for a medication assistance program, using coupons and creating a more long-term plan for getting in with a pharmacy that’s more affordable.”
Long-term, continuing to bridge the fields of social work and oral medicine will be critical for ensuring that a patient’s needs are addressed holistically, she added.
“By the time many of these medically complex patients attend their first visit with an oral medicine specialist, they have been to numerous health care providers without results,” she said. “They are often overwhelmed by their symptoms, experiencing gaps in care, and their psychosocial needs have been neglected. Having a social worker there to assess for and address those needs is a true game-changer for this patient population and their oral medicine team.”