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Behavioral Health in Primary Care

Integrating Behavioral Health into Primary Care

Primary care settings have become a gateway for many individuals with behavioral health and primary care needs. To address these needs, many primary care providers are integrating behavioral health care services into their setting. Models have emerged that include the use of care managers, behavioral health consultants, behavioralists, or consultation models. CIHS monitors activities and models around the country in order to share best practices with the primary and behavioral healthcare professionals.  



Integrated Models of Behavioral Health in Primary Care

Consumers as Partners in Improving Health was a National Council and Mental Health America presentation by Kathy Bianco, Care Plus New Jersey, and Charles Willis, Georgia Mental Health Consumer Network, that discusses how to engage consumers in reaching their personal health and wellness goals.

A Family Guide: Integrating Mental Health and Pediatric Primary Care, produced by NAMI, helps family members get involved in the integrated care movement and improve the care their children receive in pediatric primary care settings.

IMPACT (Improving Mood – Providing Access to Collaborative Treatment) integrates depression treatment into primary care and other medical settings and has been shown to be more than twice as effective as traditional depression care. IMPACT also improves physical and social functioning and patients’ quality of life while reducing overall healthcare costs. The model has been adapted and proves effective in treating depression and other mental disorders in a wide range of patients, including those with diabetes and cancer. The IMPACT Implementation Center has trained over 4,000 clinicians and supported implementation of this evidence-based program in more than 500 clinics.

Cherokee Health Systems has served its communities’ healthcare needs since 1960, upholding one simple philosophy: the best approach to wellness involves treating both body and mind. The health center offers an array of comprehensive primary care, behavioral health, dental, and prevention programs and services. 

DIAMOND (Depression Improvement Across Minnesota Offering a New Direction) addresses the way depression care is delivered in primary care and how it is paid for. Founded by the Institute for Clinical Systems Improvement (ICSI), DIAMOND enables medical groups, health plans, employers, and patients collaborate to develop an improved, evidenced-based model for managing depression.

Vermont Blueprint for Health is a cutting edge health reform program and public-private partnership that looks at the practice of medicine and chronic care and informs providers on innovations, tools, clinical guidelines, and best practices to deliver effective, proactive care and to involve patients in managing their own chronic conditions.

The Integrated Behavioral Health Project (IBHP) aims to accelerate the integration of behavioral health services into primary care settings in California.

ICARE Partnership North Carolina Project seeks to increase access to quality, evidence-based behavioral healthcare services for North Carolinians

The Massachusetts Child Psychiatry Access Project (MCPAP) is an interdisciplinary healthcare initiative that assists primary care providers who serve children and adolescents with behavioral health needs.

Best Practices: Integrating Behavioral Health and Primary Care: The Harris County Community Behavioral Health Program,” published in Psychiatric Services in April 2008, evaluates the Harris County Community Behavioral Health Program, an integrated care program operating in community health centers serving low-income uninsured residents in Houston, Texas. The study analyzed service data, provider satisfaction, patient outcomes, and appointment and waiting periods to assess the program’s initial operation.

The Macarthur Initiative on Depression & Primary Care Toolkit helps primary care clinicians recognize and manage depression and provides simple instruments and information sources for use in primary care settings. 


Models integrating Substance Use Treatment into Primary Care

For more information and resources related to SBIRT (Screening Brief Intervention and Referral to Treatment) use the Center for Integrated Health Solution's resources.

The National Institute on Drug Abuse’s screening tools help primary care and other healthcare professionals screen for tobacco, alcohol, and other drug use.

Colorado Clinical Guidelines Collaborative (CCGC) developed guidelines on universal substance use screening in primary care settings based on best evidence for routine screening for substance use. Supplemental materials including a sample brief intervention and recommended tools for further assessment of those who screen positive on the brief screen. 

Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later,” published in Drug & Alcohol Dependence, showed  significant improvements through the use of SBIRT for illicit drug and heavy alcohol use across a range of healthcare settings and a range of patients. 


Behavioral Health and Patient-Centered Medical Homes

The NCQA implemented new PCMH standards that places more emphasis on team care and also calls for behavioral health integration. In team-based care practices is it important to designate specific roles and responsibilities for team members as well as the patient who is explicitly identified as a member of the care team.

Visit CIHS' health homes page for more information and resources 


Business Case for Behavioral Health Integration

The Business Case for the Integration of Behavioral Health and Primary Care and the companion excel tool can assist you in building a sample business case for behavioral health integration. These resources and other key teachings from the 2013 NACHC led Behavioral Health Learning Community can be found below. 


ADDITIONAL RESOURCES

The American Society of Addiction Medicine (ASAM) developed a policy supporting the integration of primary care and behavioral healthcare.

The mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use disorders for non-specialist health settings, is a model guide developed by WHO. It presents protocols for clinical decision-making. The priority conditions included are: depression, psychosis, bipolar disorders, epilepsy, developmental and behavioural disorders in children and adolescents, dementia, alcohol use disorders, drug use disorders, self-harm/suicide and other significant emotional or medically unexplained complaints.


WEBINARS

Integration Models: Lessons From the Behavioral Health Field
May 23, 2012
Presented by Karen Bassett, Jen DeGroff, and Kathy Bianco

Presentation
Transcript

Introduction to Effective Behavioral Health in Primary Care
June 1, 2011
Presented by Alexander Blount

Brief Behavioral Health Interventions in Primary Care
September 14, 2011
Presented By Parinda Khatri, PhD, and Ken Mays, MD

VIDEOS

Call Our Helpline: 202.684.7457

Integrating Behavioral Health into Primary Care

Primary care settings have become a gateway for many individuals with behavioral health and primary care needs. To address these needs, many primary care providers are integrating behavioral health care services into their setting. Models have emerged that include the use of care managers, behavioral health consultants, behavioralists, or consultation models. CIHS monitors activities and models around the country in order to share best practices with the primary and behavioral healthcare professionals.  



Integrated Models of Behavioral Health in Primary Care

Consumers as Partners in Improving Health was a National Council and Mental Health America presentation by Kathy Bianco, Care Plus New Jersey, and Charles Willis, Georgia Mental Health Consumer Network, that discusses how to engage consumers in reaching their personal health and wellness goals.

A Family Guide: Integrating Mental Health and Pediatric Primary Care, produced by NAMI, helps family members get involved in the integrated care movement and improve the care their children receive in pediatric primary care settings.

IMPACT (Improving Mood – Providing Access to Collaborative Treatment) integrates depression treatment into primary care and other medical settings and has been shown to be more than twice as effective as traditional depression care. IMPACT also improves physical and social functioning and patients’ quality of life while reducing overall healthcare costs. The model has been adapted and proves effective in treating depression and other mental disorders in a wide range of patients, including those with diabetes and cancer. The IMPACT Implementation Center has trained over 4,000 clinicians and supported implementation of this evidence-based program in more than 500 clinics.

Cherokee Health Systems has served its communities’ healthcare needs since 1960, upholding one simple philosophy: the best approach to wellness involves treating both body and mind. The health center offers an array of comprehensive primary care, behavioral health, dental, and prevention programs and services. 

DIAMOND (Depression Improvement Across Minnesota Offering a New Direction) addresses the way depression care is delivered in primary care and how it is paid for. Founded by the Institute for Clinical Systems Improvement (ICSI), DIAMOND enables medical groups, health plans, employers, and patients collaborate to develop an improved, evidenced-based model for managing depression.

Vermont Blueprint for Health is a cutting edge health reform program and public-private partnership that looks at the practice of medicine and chronic care and informs providers on innovations, tools, clinical guidelines, and best practices to deliver effective, proactive care and to involve patients in managing their own chronic conditions.

The Integrated Behavioral Health Project (IBHP) aims to accelerate the integration of behavioral health services into primary care settings in California.

ICARE Partnership North Carolina Project seeks to increase access to quality, evidence-based behavioral healthcare services for North Carolinians

The Massachusetts Child Psychiatry Access Project (MCPAP) is an interdisciplinary healthcare initiative that assists primary care providers who serve children and adolescents with behavioral health needs.

Best Practices: Integrating Behavioral Health and Primary Care: The Harris County Community Behavioral Health Program,” published in Psychiatric Services in April 2008, evaluates the Harris County Community Behavioral Health Program, an integrated care program operating in community health centers serving low-income uninsured residents in Houston, Texas. The study analyzed service data, provider satisfaction, patient outcomes, and appointment and waiting periods to assess the program’s initial operation.

The Macarthur Initiative on Depression & Primary Care Toolkit helps primary care clinicians recognize and manage depression and provides simple instruments and information sources for use in primary care settings. 


Models integrating Substance Use Treatment into Primary Care

For more information and resources related to SBIRT (Screening Brief Intervention and Referral to Treatment) use the Center for Integrated Health Solution's resources.

The National Institute on Drug Abuse’s screening tools help primary care and other healthcare professionals screen for tobacco, alcohol, and other drug use.

Colorado Clinical Guidelines Collaborative (CCGC) developed guidelines on universal substance use screening in primary care settings based on best evidence for routine screening for substance use. Supplemental materials including a sample brief intervention and recommended tools for further assessment of those who screen positive on the brief screen. 

Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later,” published in Drug & Alcohol Dependence, showed  significant improvements through the use of SBIRT for illicit drug and heavy alcohol use across a range of healthcare settings and a range of patients. 


Behavioral Health and Patient-Centered Medical Homes

The NCQA implemented new PCMH standards that places more emphasis on team care and also calls for behavioral health integration. In team-based care practices is it important to designate specific roles and responsibilities for team members as well as the patient who is explicitly identified as a member of the care team.

Visit CIHS' health homes page for more information and resources 


Business Case for Behavioral Health Integration

The Business Case for the Integration of Behavioral Health and Primary Care and the companion excel tool can assist you in building a sample business case for behavioral health integration. These resources and other key teachings from the 2013 NACHC led Behavioral Health Learning Community can be found below. 


ADDITIONAL RESOURCES

The American Society of Addiction Medicine (ASAM) developed a policy supporting the integration of primary care and behavioral healthcare.

The mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use disorders for non-specialist health settings, is a model guide developed by WHO. It presents protocols for clinical decision-making. The priority conditions included are: depression, psychosis, bipolar disorders, epilepsy, developmental and behavioural disorders in children and adolescents, dementia, alcohol use disorders, drug use disorders, self-harm/suicide and other significant emotional or medically unexplained complaints.


WEBINARS

Integration Models: Lessons From the Behavioral Health Field
May 23, 2012
Presented by Karen Bassett, Jen DeGroff, and Kathy Bianco

Presentation
Transcript

Introduction to Effective Behavioral Health in Primary Care
June 1, 2011
Presented by Alexander Blount

Brief Behavioral Health Interventions in Primary Care
September 14, 2011
Presented By Parinda Khatri, PhD, and Ken Mays, MD

VIDEOS

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Phone: 202-684-7457