Integrating Behavioral Health and Primary Care

Integrating behavioral health and primary care holds promise to promote team-based treatment for patients with both medical and mental health conditions. However, implementing integration is challenging for physician practices under fee-for-service payment models. Telehealth has been an effective tool, but access to high-speed Internet is a barrier for many.

The Making Care Primary model provides an opportunity to support behavioral health integration by providing practices with resources and incentivizing them through tiered risk-sharing payments.

Behavioral health issues often co-occur with other chronic conditions

Behavioral health is an umbrella term that covers everything from lifestyle and health behaviors to addictions. It includes factors that impact a person’s emotional well-being and their sense of self. It also covers stress, depression, anxiety and other mental health conditions. Behavioral health professionals include counselors, life coaches, psychologists, psychiatric nurse practitioners and social workers.

People with behavioral health issues often co-occur with chronic medical conditions such as heart disease or diabetes. They are also at greater risk of unstable employment, unaffordable housing and involvement in the criminal justice system. This co-occurrence is particularly true in low-income communities.

Despite the clear link between behavioral and physical health, many people do not receive the help they need. In some cases, this is because they are too afraid to talk about their emotional problems with their doctors. However, there are some steps that can be taken to ensure that more people get the treatment they need. This includes integrating behavioral health into primary care and making it more accessible.

Behavioral health issues often co-occur with physical health issues

Behavioral health is the treatment of emotional and mental illnesses like depression or anxiety. It also includes treatment for substance abuse. These conditions often co-occur with physical ailments like chronic health problems or obesity. Behavioral health issues are often the root cause of many medical problems and are an important part of holistic patient care.

Integrated behavioral health recognizes that mental and physical health are inextricably linked. It provides physician practices and patients with practical solutions for addressing these issues. Behavioral health integration helps physicians better manage their patients’ overall health and improves job satisfaction for both providers and staff.

Currently, there are multiple barriers to integrating behavioral health into primary care. One is the fee-for-service payment system, which disincentives providers from integrating behavioral healthcare into their practice. Another is the need for collaborative care management (CCM) reimbursement codes, which aren’t always sufficient to cover the cost of delivering integrated care. Payers can address these barriers by forming partnerships with provider networks that support their efforts to integrate behavioral healthcare into primary care.

Behavioral health issues often co-occur with medication management

Behavioral healthcare involves treating mental illnesses and substance abuse disorders, as well as helping people change their unhealthy behaviors. This includes counseling and therapy services, but it also can include medication management. Behavioral health can help people manage their symptoms and live full lives.

However, only about half of all people who need treatment receive it. This is partly due to provider shortages. And there are racial disparities, as well.

The good news is that many providers are starting to integrate behavioral health into primary care. This is called behavioral health integration (BHI). BHI helps physicians and their teams deliver patient-centered, integrated care that improves patients’ outcomes.

Behavioral healthcare can be provided by a wide variety of healthcare providers, including psychiatrists, psychologists, psychiatric nurse practitioners, counselors, social workers, and marriage and family therapists. It can also be delivered by community organizations and private employers. Managed behavioral health programs typically utilize clinical methodologies and data-driven technologies to fully integrate with ongoing medical care.

Behavioral health issues often co-occur with care coordination

Behavioral health includes mental illness, substance use and stress. However, many people who need behavioral health care don’t receive it. This is due to a long-standing shortage of providers and to social stigma. Integrated services can help overcome this barrier.

Integrated behavioral health integrates mental and physical health to treat patients as holistic individuals. Typically, this integration involves medical and behavioral health clinicians working together in one setting. Behavioral health clinicians are sometimes located right in the medical setting, and if not onsite, they’re fully integrated into the team’s procedures and information systems.

In addition to improving patient outcomes, integrating behavioral health can improve staff retention and reduce cost. Many physicians’ practices have adopted various workflows and models for integrating behavioral health, depending on their patient population, staff capabilities and technology needs. Purchasers and quality oversight organizations can support this effort by incorporating behavioral health integration into their purchasing and quality-oversight agreements. This approach also benefits employers by supporting their employees’ mental health and well-being.