Skip to main content

Advertisement

Log in

Integration of behavioral health and primary care: current knowledge and future directions

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Integrated behavioral health in primary care has spread rapidly over the past three decades, although significant questions remain unanswered regarding best practices in clinical, financial and operational worlds. Two key models have emerged over time: care management and Primary Care Behavioral Health. Research to date has been promising; however, there is a significant need for more sophisticated multi-level scientific methodologies to fill in the gaps in current knowledge of integrated primary care. In this paper, we summarize current scientific knowledge about integrated primary care and critically evaluate the strengths and weaknesses of this knowledge base, focusing on clinical, financial and operational factors. Finally, we recommended priorities for future research, dissemination, real-world implementation, and health policy implications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Alford, D. P., LaBelle, C. T., Kretsch, N., Bergeron, A., Winter, M., Botticelli, M., et al. (2011). Collaborative care of opioid-addicted patients in primary care using buprenorphine: Five-year experience. Archives of Internal Medicine, 171(5), 425–431.

    Article  PubMed  PubMed Central  Google Scholar 

  • Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., et al. (2012). Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews, 10, 1–227. doi:10.1002/14651858.CD006525.pub2

    Google Scholar 

  • Auxier, A., Farley, T., & Seifert, K. (2011). Establishing an integrated care practice in a community health center. Professional Psychology: Research and Practice, 42(5), 391–397. doi:10.1037/a0024982

    Article  Google Scholar 

  • Ayalon, L., Areán, P. A., Linkins, K., Lynch, M., & Estes, C. L. (2007). Integration of mental health services into primary care overcomes ethnic disparities in access to mental health services between black and white elderly. The American Journal of Geriatric Psychiatry, 15(10), 906–912. doi:10.1097/JGP.0b013e318135113e

    Article  PubMed  Google Scholar 

  • Baird, M., Blount, A., Brungardt, S., Dickinson, P., Dietrich, A., Epperly, T., et al. (2014). Joint principles: Integrating behavioral health care into the patient-centered medical home. Annals of Family Medicine, 12, 183–185.

    Article  Google Scholar 

  • Barber, J. A., Frantsve, L. M., Capelli, S., & Sanders, K. A. (2011). Implementation and evaluation of an integrated care program in a VA medical center. Psychological Services, 8(4), 282. doi:10.1037/a0027645

    Article  Google Scholar 

  • Beehler, G. P., Funderburk, J. S., Possemato, K., & Dollar, K. M. (2013). Psychometric assessment of the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ). Translational Behavioral Medicine, 3(4), 379–391. doi:10.1007/s13142-013-0216-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs, 27(3), 759–769. doi:10.1377/hlthaff.27.3.759

    Article  PubMed  Google Scholar 

  • Bryan, C. J., Corso, K. A., Corso, M. L., Kanzler, K. E., Ray-Sannerud, B., & Morrow, C. E. (2012a). Therapeutic alliance and change in suicidal ideation during treatment in integrated primary care settings. Archives of Suicide Research, 16(4), 316–323.

    Article  PubMed  Google Scholar 

  • Bryan, C. J., Corso, M. L., Corso, K. A., Morrow, C. E., Kanzler, K. E., & Ray-Sannerud, B. (2012b). Severity of mental health impairment and trajectories of improvement in an integrated primary care clinic. Journal of Consulting and Clinical Psychology, 80(3), 396–403. doi:10.1037/a0027726

    Article  PubMed  Google Scholar 

  • Bryan, C. J., Morrow, C., & Appolonio, K. K. (2009). Impact of behavioral health consultant interventions on patient symptoms and functioning in an integrated family medicine clinic. Journal of Clinical Psychology, 65(3), 281–293. doi:10.1002/jclp.20539

    Article  PubMed  Google Scholar 

  • Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., et al. (2008). Integration of mental health/substance abuse and primary care. Evidence Report/Technology Assessment, 173, 1–362.

    Google Scholar 

  • Butler, M., Kane, R. L., McAlpine, D., Kathol, R., Fu, S. S., Hagedorn, H., et al. (2011). Does integrated care improve treatment for depression? A systematic review. The Journal of Ambulatory Care Management, 34(2), 113–125. doi:10.1097/JAC.0b013e31820ef605

    Article  PubMed  Google Scholar 

  • Canadian Interprofessional Health Collaborative (CIHC). (2012). An inventory of quantitative tools measuring interprofessional education and collaborative practice outcomes. CIHC. Retrieved from: http://rcrc.brandeis.edu/pdfs/Canadian%20Interprofessional%20Health%20Collaborative%20report.pdf

  • “Care Manager|University of Washington AIMS Center” (n.d.). Retrieved from http://aims.uw.edu/collaborative-care/team-structure/care-manager

  • Carey, T. S., Crotty, K. A., Morrissey, J. P., Jonas, D. E., Viswanathan, M., Thaker, S., et al. (2010). Future research needs for the integration of mental health/substance abuse and primary care: Identification of future research needs from evidence report/technology assessment No 173. Rockville: Agency for Healthcare Research and Quality (US).

    Google Scholar 

  • Chiles, J. A., Lambert, M. J., & Hatch, A. L. (1999). The impact of psychological interventions on medical cost offset: A meta-analytic review. Clinical Psychology: Science and Practice, 6(2), 204–220.

    Google Scholar 

  • Christensen, H., Griffiths, K. M., Gulliver, A., Clack, D., Kljakovic, M., & Wells, L. (2008). Models in the delivery of depression care: A systematic review of randomised and controlled intervention trials. BMC Family Practice, 9(25). doi:10.1186/1471-2296-9-25

  • Cigrang, J. A., Rauch, S. A., Avila, L. L., Bryan, C. J., Goodie, J. L., Hryshko-Mullen, A., et al. (2011). Treatment of active-duty military with PTSD in primary care: Early findings. Psychological Services, 8(2), 104–113.

    Article  Google Scholar 

  • Cigrang, J. A., Rauch, S. A., Mintz, J., Brundige, A., Avila, L. L., Bryan, C. J., et al. (2015). Treatment of active duty military with PTSD in primary care: A follow-up report. Journal of Anxiety Disorders, 36, 110–114.

    Article  PubMed  Google Scholar 

  • Craven, M. A., & Bland, R. (2006). Better practices in collaborative mental health care: An analysis of the evidence base. Canadian Journal of Psychiatry, 51(6 Suppl 1), 7S–72S.

    PubMed  Google Scholar 

  • Cuijpers, P., van Straten, A., van Schaik, A., & Andersson, G. (2009). Psychological treatment of depression in primary care: A meta-analysis. British Journal of General Practice, 59(559), e51–e60.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cummings, N. A., O’Donohue, W. T., & Cummings, J. L. (2009). The financial dimension of integrated behavioral/primary care. Journal of Clinical Psychology in Medical Settings, 16(1), 31–39. doi:10.1007/s10880-008-9139-2

    Article  PubMed  Google Scholar 

  • Davies, G. P., Williams, A. M., Larsen, K., Perkins, D., Roland, M., & Harris, M. F. (2008). Coordinating primary health care: An analysis of the outcomes of a systematic review. Medical Journal of Australia, 188, S65–S68.

    Google Scholar 

  • Davis, M. M., Balasubramanian, B. A., Cifuentes, M., Hall, J., Gunn, R., Fernald, D., et al. (2015). Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care. The Journal of the American Board of Family Medicine, 28(Supplement 1), S32–S40.

    Article  PubMed  Google Scholar 

  • Davis, M., Balasubramanian, B. A., Waller, E., Miller, B. F., Green, L. A., & Cohen, D. J. (2013). Integrating behavioral and physical health care in the real world: Early lessons from advancing care together. The Journal of the American Board of Family Medicine, 26(5), 588–602. doi:10.3122/jabfm.2013.05.130028

    Article  PubMed  Google Scholar 

  • deGruy, F. (1996). Mental health care in the primary care setting. In K. Donaldson, K. Yordy, K. Lohr, & N. Vanselow (Eds.), Primary care: America’s health in a new era. Washington, DC: Institute of Medicine, National Academy Press.

    Google Scholar 

  • Department of Defense. (2013). Integration of Behavioral Health Personnel (BHP) Services into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings. DoD instruction number 6490.15 (Incorporating Change 2, Effective November 20, 2014). http://dtic.mil/whs/directives/corres/pdf/649015p.pdf

  • Dietrich, A. J., Oxman, T. E., Williams, J. W., Kroenke, K., Schulberg, H. C., Bruce, M., et al. (2004). Going to scale: Re-engineering systems for primary care treatment of depression. Annals of Family Medicine, 2(4), 301–304.

    Article  PubMed  PubMed Central  Google Scholar 

  • “Dollars & Cents | University of Washington AIMS Center” (n.d.). Retrieved from http://aims.uw.edu/collaborative-care/dollars-sense

  • Donabedian, A. (1980). The definition of quality and approaches to its assessment: Vol. 1. Explorations in quality assessment and monitoring. Ann Arbor: Health Administration Press.

    Google Scholar 

  • Ell, K., Katon, W., Xie, B., Lee, P.-J., Kapetanovic, S., Guterman, J., et al. (2010). Collaborative care management of major depression among low-income, predominantly Hispanic subjects with diabetes: A randomized controlled trial. Diabetes Care, 33(4), 706–713. doi:10.2337/dc09-1711

    Article  PubMed  PubMed Central  Google Scholar 

  • Engel, C. C., Bray, R. M., Jaycox, L. H., Freed, M. C., Zatzick, D., Lane, M. E., et al. (2014). Implementing collaborative primary care for depression and posttraumatic stress disorder: Design and sample for a randomized trial in the U.S. military health system. Contemporary Clinical Trials, 39(2), 310–319. doi:10.1016/j.cct.2014.10.002

    Article  PubMed  Google Scholar 

  • Gilbody, S., Bower, P., & Whitty, P. (2006). Costs and consequences of enhanced primary care for depression: Systematic review of randomised economic evaluations. The British Journal of Psychiatry: The Journal of Mental Science, 189, 297–308. doi:10.1192/bjp.bp.105.016006

    Article  Google Scholar 

  • Gilbody, S., Whitty, P., Grimshaw, J., & Thomas, R. (2003). Educational and organizational interventions to improve the management of depression in primary care: A systematic review. JAMA, 289(23), 3145–3151. doi:10.1001/jama.289.23.3145

    Article  PubMed  Google Scholar 

  • Goodie, J. L., Isler, W. C., Hunter, C., & Peterson, A. L. (2009). Using behavioral health consultants to treat insomnia in primary care: A clinical case series. Journal of Clinical Psychology, 65, 294–304. doi:10.1002/jclp.20548

    Article  PubMed  Google Scholar 

  • Hall, J., Cohen, D. J., Davis, M., Gunn, R., Blount, A., Pollack, D. A., et al. (2015). Preparing the workforce for behavioral health and primary care integration. The Journal of the American Board of Family Medicine, 28(Supplement 1), S41–S51.

    Article  PubMed  Google Scholar 

  • Heath, B., Wise Romero, P., & Reynolds, K. (2013). A standard framework for levels of integrated healthcare. Washington, DC: SAMHSAHRSA Center for Integrated Health Solutions. Retrieved from http://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdf

  • Hegel, M., & Arean, P. A. (2003). Problem-solving treatment for primary care: A treatment manual for depression. Lebanon, NH: Project IMPACT: Dartmouth College.

    Google Scholar 

  • Hillemeier, M. M., Lynch, J., Harper, S., & Casper, M. (2003). Measuring contextual characteristics for community health. Health Services Research, 38, 1645–1718. doi:10.1111/j.1475-6773.2003.00198.x

    Article  PubMed  PubMed Central  Google Scholar 

  • Hostetler, C., Sisulak, L., Cottrell, E., Arkind, J., & Likumahuwa, S. (2014). Origins in Oregon: The alternative payment methodology project. Retrieved from http://healthaffairs.org/blog/2014/04/14/origins-in-oregon-the-alternative-payment-methodology-project

  • Huang, Y., Wei, X., Wu, T., Chen, R., & Guo, A. (2013). Collaborative care for patients with depression and diabetes mellitus: A systematic review and meta-analysis. BMC Psychiatry, 13, 260. doi:10.1186/1471-244X-13-260

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hunter, C. L., & Goodie, J. L. (2010). Operational and clinical components for integrated-collaborative behavioral healthcare in the patient-centered medical home. Families, Systems, & Health, 28, 308–321. doi:10.1037/a0021761

    Article  Google Scholar 

  • Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2009). Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Institute of Medicine (IOM). (1996). Defining primary care. In M. Donaldson, K. Yordy, & K. Lohr (Eds.), Primary Care: America’s health in a new era. Washington, DC: National Academy Press.

    Google Scholar 

  • Institute of Medicine (IOM). (2015). Psychosocial interventions for mental and substance use disorders: A framework for establishing evidence-based standards. Washington, DC: National Academies Press.

    Google Scholar 

  • Johnson, J. A., Al Sayah, F., Wozniak, L., Rees, S., Soprovich, A., Qiu, W., et al. (2014). Collaborative care versus screening and follow-up for patients with diabetes and depressive symptoms: results of a primary care-based comparative effectiveness trial. Diabetes Care, 37(12), 3220–3226. doi:10.2337/dc14-1308

    Article  PubMed  Google Scholar 

  • Jonas, D. E., Garbutt, J. C., Amick, H. R., Brown, J. M., Brownley, K. A., Council, C. L., et al. (2012). Behavioral counseling after screening for alcohol misuse in primary care: A systematic review and meta-analysis for the U.S. preventive services task force. Annals of Internal Medicine, 157(9), 645–654. doi:10.7326/0003-4819-157-9-201211060-00544

    Article  PubMed  Google Scholar 

  • Katon, W., Lin, E. H. B., & Kroenke, K. (2007). The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry, 29(2), 147–155. doi:10.1016/j.genhosppsych.2006.11.005

    Article  PubMed  Google Scholar 

  • Kearney, L. K., Wray, L. O., Dollar, K. M., & King, P. R. (2015). Establishing measurement-based care in integrated primary care: Monitoring clinical outcomes over time. Journal of Clinical Psychology in Medical Settings, 22(4), 213–227. doi:10.1007/s10880-015-9443-6

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., et al. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine, 352(24), 2515–2523.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kinman, C. R., Gilchrist, E. C., Payne-Murphy, J. C., & Miller, B. F. (2015). Provider- and practice-level competencies for integrated behavioral health in primary care: A literature review. Rockville: Agency for Healthcare Research and Quality.

    Google Scholar 

  • Kwan, B., & Nease, D. (2013). The state of the evidence for integrated behavioral health in primary care. In M. R. Talen & A. B. Valeras (Eds.), Integrated behavioral health in primary care: Evaluating the evidence, identifying the essentials (pp. 65–98). New York: Springer.

    Chapter  Google Scholar 

  • Linde, K., Sigterman, K., Kriston, L., Rucker, G., Jamil, S., Meissner, K., et al. (2015). Effectiveness of psychological treatments for depressive disorders in primary care: Systematic review and meta-analysis. Annals of Family Medicine, 13(1), 56–68. doi:10.1370/afm.1719

    Article  PubMed  PubMed Central  Google Scholar 

  • Martin, M. P., White, M. B., Hodgson, J. L., Lamson, A. L., & Irons, T. G. (2014). Integrated primary care: A systematic review of program characteristics. Families, Systems & Health: The Journal of Collaborative Family Healthcare, 32(1), 101–115. doi:10.1037/fsh0000017

    Article  Google Scholar 

  • Mauksch, L. B., & Fogarty, C. T. (2016). In search of a perennial philosophy for behavioral health integration in primary care. Families, Systems, & Health, 34(2), 79–82. doi:10.1037/fsh0000196

    Article  Google Scholar 

  • McDaniel, S. H., Grus, C. L., Cubic, B. A., Hunter, C. L., Kearney, L. K., Schuman, C. C., et al. (2014). Competencies for psychology practice in primary care. American Psychologist, 69, 409–429. doi:10.1037//a0036072

    Article  PubMed  Google Scholar 

  • Miller, B., Gilchirst, E., Ross, K., Wong, S., Blount, A., & Peek, C. J. (2016). Care competencies for behavioral health providers working in primary care. Colorado consensus conference.

  • Miller, B. F., Kessler, R., Peek, C. J., & Kallenberg, G. A. (2011). A national research agenda for research in collaborative care. Papers from the Collaborative Care Research Network Research Development Conference (AHRQ publication no. 11-0067). Rockville, MD: Agency for Health Care Research and Quality. Retrieved from http://archive.ahrq.gov/research/findings/final-reports/collaborativecare/collab1.html

  • Miranda, J., Schoenbaum, M., Sherbourne, C., Duan, N., & Wells, K. (2004). Effects of primary care depression treatment on minority patients’ clinical status and employment. Archives of General Psychiatry, 61(8), 827–834. doi:10.1001/archpsyc.61.8.827

    Article  PubMed  Google Scholar 

  • Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. JAMA, 291(10), 1238–1245.

    Article  PubMed  Google Scholar 

  • Monson, S. P., Sheldon, J. C., Ivey, L. C., Kinman, C. R., & Beacham, A. O. (2012). Working toward financial sustainability of integrated behavioral health services in a public health care system. Families, Systems, & Health, 30(2), 181–186. doi:10.1037/a0028177

    Article  Google Scholar 

  • Nafziger, M., & Miller, M. (2013). Collaborative primary care: Preliminary findings for depression and anxiety (Doc. No. 13–10-3401). Olympia: Washington State Institute for Public Policy. Retrieved from http://www.wsipp.wa.gov/ReportFile/1546/Wsipp_Collaborative-Primary-Care-Preliminary-Findings-for-Depression-and-Anxiety_Preliminary-Report.pdf

  • National Committee for Quality Assurance [NCQA]. (2014). Standards and guidelines for NCQA’s patient-centered medical home (PCMH) 2014. Retrieved from http://store.ncqa.org/index.php/2014-pcmh-standards-and-guidelines-epub-single-user.html

  • Nielsen, M., Gibson, A., Buelt, L., Grundy, P., & Grumbach, K. (2015). The patient-centered medical home’s impact on cost and quality: Annual review of evidence, 2013–2014. Washington (DC): Patient-Centered Primary Care Collaborative.

    Google Scholar 

  • Nielsen, M., Olayiwola, J. N., Grundy, P., Grumbach, K., (Ed.), & Shalijan, M. (2014). The patient-centered medical home’s impact on cost and quality: An annual update of the evidence, 2012–2013. Washington, DC: Patient-Centered Primary Care Collaborative.

  • Oxman, T. E., Dietrich, A. J., Williams, J. W., & Kroenke, K. (2002). A three-component model for reengineering systems for the treatment of depression in primary care. Psychosomatics, 43(6), 441–450.

    Article  PubMed  Google Scholar 

  • Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010).

  • Peek, C. J. (2008). Planning care in the clinical, operational, and financial worlds. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice. New York: Springer.

    Google Scholar 

  • Peek, C. J., & National Integration Academy Council. (2013). Lexicon for behavioral health and primary care integration: Concepts and definitions developed by expert consensus (AHRQ Publication No.13-IP001-EF). Rockville, MD: Agency for Health Care Research and Quality. Retrieved from: http://integrationacademy.ahrq.gov/sites/default/files/Lexicon.pdf

  • Peek, C. J., Glasgow, R. E., Stange, K. C., Klesges, L. M., Purcell, E. P., & Kessler, R. S. (2014). The 5 R’s: An emerging bold standard for conducting relevant research in a changing world. The Annals of Family Medicine, 12(5), 447–455. doi:10.1370/afm.1688

    Article  CAS  PubMed  Google Scholar 

  • Petterson, S. M., Phillips, R. L., Jr., Bazemore, A. W., Dodoo, M. S., Zhang, X., & Green, L. A. (2008). Why there must be room for mental health in the medical home. American Family Physician, 77(6), 757.

    PubMed  Google Scholar 

  • “Policy and Financing|The Academy” (n.d.). Retrieved from http://integrationacademy.ahrq.gov/policy

  • Post, E. P., Miller, M. D., & Schulberg, H. C. (2008). Using interpersonal psychotherapy (IPT) to treat depression in older primary care patients. Geriatrics, 63, 18–28.

    PubMed  Google Scholar 

  • Ray-Sannerud, B. N., Dolan, D. C., Morrow, C. E., Corso, K. A., Kanzler, K. E., Corso, M. L., et al. (2012). Longitudinal outcomes after brief behavioral health intervention in an integrated primary care clinic. Families, Systems, & Health, 30(1), 60–71.

    Article  Google Scholar 

  • Regier, D. A., Farmer, M. E., Rae, D. S., Myers, J. K., Kramer, M., Robins, L. N., et al. (1993a). One-month prevalence of mental disorders in the United States and sociodemographic characteristics: The Epidemiologic Catchment Area study. Acta Psychiatric Scandinavica, 88(1), 35–47.

    Article  CAS  Google Scholar 

  • Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Locke, B. Z., & Goodwin, F. K. (1993b). The de facto us mental and addictive disorders service system: Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 50(2), 85–94. doi:10.1001/archpsyc.1993.01820140007001

    Article  CAS  PubMed  Google Scholar 

  • Robinson, P. J., Gould, D., & Strosahl, K. (2011). Real behavior change in primary care: Improving patient outcomes and increasing job satisfaction. Oakland: New Harbinger.

    Google Scholar 

  • Robinson, P. J., & Reiter, J. T. (2016). Behavioral consultation and primary care: A guide to integrating services (2nd ed.). New York: Springer.

    Book  Google Scholar 

  • Robinson, P., & Strosahl, K. D. (2008). The mindfulness and acceptance workbook for depression: Using acceptance and commitment therapy to move through depression and create a life worth living. Oakland, CA: New Harbinger.

    Google Scholar 

  • Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., et al. (2010). Delivery of evidence-based treatment for multiple anxiety disorders in primary care: A randomized controlled trial. JAMA, 303(19), 1921–1928.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sanchez, K., Chapa, T., Ybarra, R., & Martinez, O. N. (2012). Eliminating disparities through the integration of behavioral health and primary care services for racial and ethnic minorities, including populations with limited English proficiency: A review of the literature. U.S. Department of Health and Human Services, Office of Minority Health and the Hogg Foundation for Mental Health.

  • Scott, K., & Lewis, C. C. (2015). Using measurement-based care to enhance any treatment. Cognitive and Behavioral Practice, 22(1), 49–59. doi:10.1016/j.cbpra.2014.01.010

    Article  PubMed  PubMed Central  Google Scholar 

  • Serrano, N., & Monden, K. (2011). The effect of behavioral health consultation on the care of depression by primary care clinicians. WMJ: Official Publication of the State Medical Society of Wisconsin, 110(3), 113–118.

    Google Scholar 

  • Sharpe, M., Walker, J., Hansen, C. H., Martin, P., Symeonides, S., Gourley, C., et al. (2014). Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): A multicentre randomised controlled effectiveness trial. The Lancet, 384(9948), 1099–1108.

    Article  Google Scholar 

  • Stewart, J. C., Perkins, A. J., & Callahan, C. M. (2014). Effect of collaborative care for depression on risk of cardiovascular events: Data from the IMPACT randomized controlled trial. Psychosomatic Medicine, 76(1), 29.

    Article  PubMed  Google Scholar 

  • Strosahl, K. (1998). Integrating behavioral health and primary care services: The primary mental health care model. In A. Blount (Ed.), Integrated primary care: The future of medical and mental health collaboration. New York: W.W. Norton.

    Google Scholar 

  • Strosahl, K. (2001). The integration of primary care and behavioral health. In N. Cummings, W. O’Donohue, S. Hayes, & V. Follette (Eds.), Integrated behavioral healthcare: Positioning mental health practice with medical/surgical practice (pp. 45–70). New York: Academic Press.

    Chapter  Google Scholar 

  • Strosahl, K. D., Robinson, P. J., & Gustavsson, T. (2012). Brief interventions for radical change: Principles and practice of focused acceptance and commitment therapy. Oakland: New Harbinger Publications.

    Google Scholar 

  • The Meadows Mental Health Policy Institute. (2016). Best practices in integrated behavioral health: Identifying and implementing core components [White paper]. Report commissioned by the St. David’s Foundation, Austin, TX.

  • United States Air Force. (2014). Primary Care Behavioral Health Services: Behavioral Health Optimization Program (BHOP) practice manual. San Antonio, TX: Air Force Medical Operations Agency.

    Google Scholar 

  • Unützer, J. (2016). All hands on deck. . Psychiatric News, 51, 1. doi:10.1176/appi.pn.2016.3a28

    Google Scholar 

  • Unützer, J., Katon, W. J., Fan, M.-Y., Schoenbaum, M. C., Lin, E. H. B., Della Penna, R. D., et al. (2008). Long-term cost effects of collaborative care for late-life depression. The American Journal of Managed Care, 14(2), 95–100.

    PubMed  PubMed Central  Google Scholar 

  • Unützer, J., Katon, W., Williams, J. W., Jr., Callahan, C. M., Harpole, L., Hunkeler, E. M., et al. (2001). Improving primary care for depression in late life: The design of a multicenter randomized trial. Medical Care, 39(8), 785–799.

    Article  PubMed  Google Scholar 

  • Vera, M., Perez-Pedrogo, C., Huertas, S. E., Reyes-Rabanillo, M. L., Juarbe, D., Huertas, A., et al. (2010). Collaborative care for depressed patients with chronic medical conditions: A randomized trial in Puerto Rico. Psychiatric Services, 61(2), 144–150.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wagner, E. H., Austin, B. T., & Von Korff, M. (1996). Organizing care for patients with chronic illness. The Milbank Quarterly, 74(4), 511–544.

    Article  CAS  PubMed  Google Scholar 

  • Waxmonsky, J., Auxier, A., Heath, B., & Wise Romero, P. (2014). Integrated practice assessment tool. Washington, DC: SAMHSAHRSA Center for Integrated Health Solutions. Retrieved from http://www.integration.samhsa.gov/operations-administration/IPAT_v_2.0_FINAL.pdf

  • Whitebird, R. R., Solberg, L. I., Jaeckels, N. A., Pietruszewski, P. B., Hadzic, S., Unützer, J., et al. (2014). Effective implementation of collaborative care for depression: What is needed? The American Journal of Managed Care, 20(9), 699–707.

    PubMed  PubMed Central  Google Scholar 

  • Whitlock, E. P., Polen, M. R., Green, C. A., Orleans, T., Klein, J., & U.S. Preventive Services Task Force. (2004). Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 140(7), 557–568.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Special thanks to Claudio Nigg, Amy Janke & Danielle Schoffman for their efforts in organizing this series of manuscripts.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark E. Vogel.

Ethics declarations

Conflict of interest

Mark E. Vogel, Kathryn E. Kanzler, James E. Aikens and Jeffrey L. Goodie declare that they have no conflict of interest.

Human and animal rights and Informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vogel, M.E., Kanzler, K.E., Aikens, J.E. et al. Integration of behavioral health and primary care: current knowledge and future directions. J Behav Med 40, 69–84 (2017). https://doi.org/10.1007/s10865-016-9798-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-016-9798-7

Keywords

Navigation