Insights From the Field: Behavioral Care Coordinator Sam Conway, LCSW

For Sam Conway, LCSW, becoming a behavioral care coordinator at the Northwestern Medicine Collaborative Behavioral Health Program (CBHP) was a natural fit. The role brings together the parts of care she values most: careful listening, whole-person assessment, patient education, psychiatric consultation, medication follow-up and close coordination with the primary care team.

“I genuinely love doing the intersectional psychiatric work,” she says.

With a background in social work, motivational interviewing and behavior change, and a strong interest in psychiatric medication management, Conway was drawn to the role for its clinical and relational aspects. In CBHP, she’s not only tracking symptoms or checking a box after a referral. She is helping patients understand what they are experiencing, what their options are and how the care team can support them between visits.

That often means looking beyond a diagnosis or a score on a screening tool. Conway considers the full context of a patient’s life and health, including sleep, chronic pain, pregnancy and postpartum needs, perimenopause, migraines, vitamin deficiencies, medication side effects and other medical conditions that can overlap with depression or anxiety.

“When you’re caring for someone in this type of role, you have their whole chart,” says Conway. “Treating someone as a whole person, you’ll see those things.”

Mental Health Care Is Healthcare

That whole-person lens is central to why Conway believes access to mental health care matters.

“Mental health care is healthcare,” she says. “I believe healthcare is a human right. It’s that simple. Everyone deserves access.”

Conway does not provide therapy in her role, although her conversations with patients are often therapeutic. Her work is collaborative, structured, practical and highly personalized. She completes intake assessments, consults with the psychiatric consultant, communicates recommendations to the primary care clinician, monitors symptoms, follows up on medication use and side effects, and connects patients with therapy or other community resources when needed.

For primary care clinicians, that structure can be especially valuable. The collaborative care model gives primary care physicians timely behavioral health input without requiring patients to navigate the mental health system on their own. It also gives patients a consistent point of contact who can help them understand the plan, raise concerns early and stay engaged in care.

Support Between Appointments

The time between appointments is where many patients need the most support. Conway checks in about whether a patient started a medication, how they are taking it, whether side effects are manageable and whether symptoms are improving at the expected pace. If a patient is not improving after a dose change, she brings the case back to the psychiatric consultant so the team can discuss whether the treatment plan should be adjusted.

These touchpoints help patients feel less alone while they wait for their next appointment. Conway typically talks with patients every one to three weeks, depending on clinical need. Someone experiencing side effects may need weekly check-ins for a period of time, while someone who is improving may need less frequent support. Patients can also message her between calls.

“I encourage people to message me instead of Googling,” she says. “They trust me, and I’ll let them know if something is an issue or if it’s normal, and I’ll let both doctors know so they can weigh in.”

The Impact of the Right Care at the Right Time

The value of that support is clear in one patient story Conway shared. The patient came to the program after years of working with different clinicians and experiencing significant symptoms that affected daily life.

Through CBHP, Conway worked with the psychiatric consultant and primary care physician to optimize the patient’s treatment plan. She also helped connect the patient with a specialized therapist and collaborated with the therapist early in treatment so everyone supporting the patient was aligned.

Over about six months, the patient’s symptoms improved significantly. They reduced their use of medication and began managing situations that had previously felt overwhelming. By the time they were discharged from CBHP, the patient expressed feeling safe and cared for in a way they had not experienced with other clinicians.

Trust Across the Care Team

For Conway, the story reflects what collaborative care can make possible when the model works well: timely support, thoughtful medication optimization, targeted therapy referrals and a team that trusts one another.

“We all have to trust each other,” she says. “If we do, this goes really smoothly. We can get people better so much faster.”

That trust extends across the care team. Primary care physicians have told Conway they are impressed by the quality of care patients receive through the program and by how quickly some patients improve. Her psychiatric consultant has also emphasized the value of frequent patient touchpoints.

“The same patient might improve on the same medication in a different setting,” says Conway, “But we see faster improvement here.”

Progress Patients Can Feel

The outcomes Conway sees are not limited to symptom scores. Patients often report that they are functioning better in daily life: communicating more easily with spouses, parenting in more values-aligned ways, gaining motivation, looking for jobs, dating, keeping up with housework or feeling ready to do deeper work in therapy.

“Many report feeling more like themselves again,” she says.

Supporting the People Who Support Patients

For other behavioral care coordinators, Conway recommends shadowing experienced colleagues, asking questions, consulting with peers, and building skills in motivational interviewing and other collaborative communication approaches.

“Patients and I are collaborating on their care,” she says. “They’re the expert on themselves.”

As collaborative care models continue to expand, Conway’s experience offers an important reminder: better mental health care does not happen through medication, therapy or access alone. It happens when patients are supported by a coordinated team — and when behavioral care coordinators are empowered to help that team work at its best.

Looking for more guidance on building and sustaining integrated behavioral health programs? Explore additional tools and resources from Northwestern Medicine West Health Accelerator.