Integrating Behavioral Health Services in the Primary Care Setting

Integrating behavioral healthcare services into a primary care practice setting is not as simple as co-locating behavioral health providers with medical providers. Integration is not achieved just because the patient receives both behavioral healthcare and traditional medical services at the same practice. Integration could take various forms, depending on the particular model adopted by the practice, but one element is common to all successful examples: the system of care delivery is transformed throughout the practice, effecting changes across the workforce, administration, clinical operations and more.

The Workforce Challenge

Behavioral health integration requires patient-centered care teams where behavioral health and primary care providers, along with support staff, collaborate on the whole health of a patient. Several barriers exist in the implementation of a collaborative care approach. One obstacle most practices face is with staffing. Since behavioral health integration in practice is a relatively new care model, and because the traditional approaches to care differ significantly in behavioral health systems and primary care clinics, the available workforce already possessing the requisite experience in such setting as well as the core competencies needed for success is limited.

Core Competencies of Collaborative Care Team Members

All members of the integrated care team require certain core competencies. Staff:

• Must be open to learning and following evidence-based practices.
• Should enjoy or at least appreciate collaboration.
• Need to be open to feedback and be communicative with team members.
• Must be willing to change strategies when necessary.
• Require flexibility and the ability to adapt.

Skills Primary Care Providers Should Develop

Primary care providers require additional training and competencies when working in collaboration with behavioral health clinicians. For example, primary care providers should:

• Be able to identify patients’ mental and emotional needs and challenges as well as recognize possible behavioral components to medical issues.
• Be open to sharing patient care with others and recognize the value of other care professionals’ expertise.
• Learn about different screening tools available to assess the psychosocial needs of patients.
• Develop clinical interviewing skills so they can more effectively and efficiently gather the necessary information to share with behavioral healthcare providers when doing a “warm hand-off” of the patient.

Skills Behavioral Health Clinicians Should Develop

Many behavioral health clinicians might not be a good fit for working in the primary care setting since the medical clinic differs from the typical specialty mental health setting in several ways:

• The workspace is different physically, from layout to level of activity.
• The number of sessions with patients is fewer in the primary care setting, as is the length of those sessions, which are more likely to provide brief interventions or assessments for a specific issue rather than more in-depth counseling.
• Communicating with other care team members will require an adjustment since behavioral healthcare clinicians have been trained with an emphasis on confidentiality.

To more effectively practice in a primary care setting, behavioral health clinicians should:

• Learn how to manage brief encounters effectively and develop treatment plans based on limited information.
• Become comfortable with frequent interruptions.

Are you interested in exploring your options in non-traditional care settings, such as an integrated behavioral health care clinic? Contact Adaptive Medical Partners to discuss some possibilities for advancing your career.