THE DEVELOPMENT OF JOINT PRINCIPLES: INTEGRATING BEHAVIORAL HEALTH CARE INTO THE PATIENT-CENTERED MEDICAL HOME

The world of primary care was galvanized in 2007 by the publication of the Joint Principles of The Patient-Centered Medical Home (PCMH) that spells out the fundamental features of a primary health care setting in which a team of clinicians offers accessible first-contact primary care.¹ This care should be personal, coordinated, continuous, and comprehensive—it should address most or all of a person’s health care needs.

Comprehensiveness confers value to the PCMH, and is an especially important principle.² By some means, “all of a person’s health care needs” must be addressed in the PCMH. This cannot be achieved without including the behavioral aspects of health. Yet comprehensiveness often is not achieved in PCMH efforts because behavioral issues are not addressed. This shortfall requires redress.

Representatives from 6 national Family Medicine Organizations, the American Academy of Family Physicians (AAFP), the American Board of Family Medicine (ABFM), the Association of Departments of Family Medicine (ADFM), the Association of Family Medicine Residency Directors (AFMRD), the North American Primary Care Research Group (NAPCRG), and the Society of Teachers of Family Medicine (STFM) came together to draft and endorse a set of Joint Principles for Integrating Behavioral Health Care into the Patient-Centered Medical Home.³ This in no way supplants the original Joint Principles document, but instead stands as a codicil that elaborates a rarely followed principle implied in the original document.

This draft was forwarded to the signers of the original Joint Principles document—the American Academy of Pediatrics (AAP), the American Osteopathic Association (AOA), and the American College of Physicians (ACP)—for comments and endorsement. Two of these 3 organizations—the AOA and the AAP—negotiated a few editorial changes and then endorsed the new Joint Principles presented here. In addition, the Collaborative Family Healthcare Association (CFHA) and the American Psychological Association (APA) have tendered endorsements.

Integrated behavioral health care is a core principle of the PCMH. This document establishes the primacy of that principle.

• © 2014 Annals of Family Medicine, Inc.