Primary Care in Behavioral Health
Primary Care in Behavioral Health
Integrating care is vital to addressing all the healthcare needs of individuals with mental health and substance use problems—regardless of whether primary care services are integrated into behavioral health systems, or vice versa. Many integrated care models illustrate the successful integration of primary care into behavioral healthcare, and can guide behavioral healthcare organizations in integrating primary care into their own service system.
SAMHSA awarded 100 community behavioral health organizations more than $26.2 million collectively in Primary and Behavioral Health Care Integration. The PBHCI Grant program is part of an effort by Congress and the Health and Human Services Administration to help prevent and reduce chronic disease and promote wellness by treating behavioral health needs on equal footing with other health conditions. CIHS provides a robust array of training and technical assistance to PBHCI grantees who are leading the national charge of integrating primary care and behavioral health services.
The Milbank Memorial Fund prepared a report, “Integrating Primary Care into Behavioral Health Settings: What Works for Individuals with Serious Mental Illness”, to better understand the significant gaps in the health care of people with serious mental illness. These gaps result in high rates of physical conditions, shorter life expectancies and higher health care costs. For two decades, research has shown that behavioral health integration (BHI)—a patient-centered approach in which behavioral health and medical providers work together to provide care—can benefit patients with depression and anxiety disorder. Much less is known about behavioral health integration models that target people with serious mental illness.
The Evaluation of the SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Grant Program: Final Report describes the RAND Corporation’s evaluation of the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Primary and Behavioral Health Care Integration (PBHCI) grants program. The PBHCI grants were designed to improve the overall wellness and physical health status of people with serious mental illness (SMI) and/or co-occurring substance use disorders (SUDs) by supporting the integration of primary care (PC) and preventive physical health services into community behavioral health (BH) centers where individuals already receive care. The evaluation brief highlights information about the grantees’ implementation of PBHCI, consumer outcomes, and PBHCI program features associated with consumer-level processes and outcomes of care.
Fragmentation of the health care system can lead to disjointed care and can result in increased health care costs. The Kaiser Family Foundation’s new issue brief, Integrating Physical and Behavioral Health Care: Promising Medicaid Models, examines five promising approaches currently underway in Medicaid to better integrate physical and behavioral health care. The five approaches include universal screening, navigators, co-location, health homes, and system-level integration.
Innovations in Addictions Treatment: Addiction Treatment Providers Working with Integrated Primary Care Services shares insights and perspectives from organizations that integrate addiction and primary care services. It is structured around the aspects of the organizations’ integrated services, including events that precipitated their integration efforts, common and significant challenges, and lessons learned, with additional information to help other substance abuse providers integrate service delivery with primary care.
Resources for Integrated Care (RIC) represents the collaboration between the Medicare-Medicaid Coordination Office (MMCO) in the Centers for Medicare & Medicaid Services (CMS), The Lewin Group, and the Institute for Healthcare Improvement to support plans and providers in their efforts to deliver more integrated, coordinated care to Medicare-Medicaid enrollees.
The Resources for Integrated Care library allows users to browse through the RIC resource collection by resource category (e.g. tools or webinars); stakeholder group (e.g. providers or health plans); target population (e.g. I/DD or SMI); or concept (self-management or navigation).
Approaches To Integrating Primary Care Services Into Behavioral Health Organizations. This guide lays out a continuum of primary care and behavioral health integration, beginning with engaging individuals with severe mental illness in discussions about their physical health to providing fully integrated services.
The Agency for Healthcare Research and Quality commissioned the University of North Carolina at Chapel Hill to develop a Health Literacy Universal Precautions Toolkit. The toolkit offers primary care practices a way to assess their services for health literacy considerations, raise awareness of the entire staff, and work on specific areas.
Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) is an evidence-based learning approach jointly developed by AHRQ and the Department of Defense (DoD). It is aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals.and includes a comprehensive set of ready-to-use materials and a training curriculum to successfully integrate teamwork principles into any health care system.
An adaptation of Standford's Chronic Disease Self-Management Program for mental health consumers, HARP is a peer-led, manualized program designed to improve individuals' self-management of chronic illnesses.
Primary Care Access, Referral, and Evaluation study (PCARE) is a team-based model of medical care management for individuals with serious mental illnesses.
Colorado Behavioral Healthcare Council’s Integrated Care Mapping Project is meant to serve both body and mind, members of the Colorado Behavioral Healthcare Council have embarked on collaborative programs with other healthcare providers around the state. This map indicates where these important programs are taking place and the strategies being used to succeed.
Working Together: FQHCs and Community Behavioral Health Organizations
(Recorded October 27, 2009)
The National Council for Community Behavioral Healthcare Working Together Webinar generated over 261 participant questions; responses are available in a Q&A Fact Sheet.
An InTimeTV Insights in Medicine interview with Dr. Peter Weiden, professor of psychiatry and director, Psychotic Disorders Program at the University of Illinois–Chicago, discusses the importance of addressing, and the challenges in managing, the medical problems of patients with severe mental illness.