Although the integration of behavioral health and primary care has long been an initiative of many nationally recognized organizations, such as the Health Resources and Services Administration (HRSA), the onset of the COVID-19 pandemic forced many health centers to expedite implementation of the model.  The goal of an integrated care model is to provide care that reflects a “whole person” approach, whereby clinicians collaborate to not only address primary care needs, but also behavioral health issues such as depression, anxiety, and substance abuse.     

Oftentimes, behavioral health issues are identified during primary care visits, making the primary care provider the first individual to see opportunities for the implementation of behavioral health services.   The process for integrating behavioral health and primary care can be challenging, depending on the size, complexity and characteristics of the health center’s patient population.  Below are some basic factors to consider when integrating behavioral health with primary care.

• Start small – If your health center is small, do not be intimidated by larger health centers that have a complex behavioral health program.  Embedding one or two individuals into the care team offers providers the opportunity to refer patients to someone with expertise in the area of behavioral health.

• Chronic health conditions – Evaluate the patient population to determine the primary/prevalent chronic health conditions, as well as comorbidities.  Patients with chronic health conditions are often more likely to have behavioral health issues.

• Policies and Procedures – Implement solid policies and standard operating procedures for the screening of all patients.  Ensure clinical support staff have the training necessary to complete screenings such as the PHQ-9, so results are available to the primary care provider upon entry into the exam room.

• Access to Care – Ensure the model implemented by the health center supports immediate access to care.  Something as simple as a “warm hand-off” by the primary care provider to a behavioral health professional can establish a connection and facilitate further treatment planning. It is important to remember that patients who are placed on a lengthy waiting list or are referred to other resources often do not follow through with treatment. 

Additional resources to assist with the integration of behavioral health and primary care can be found at:

Agency for Healthcare Research and Quality (AHRQ) – What is Integrated Behavioral Health? | The Academy (ahrq.gov)