Integrating Mental Health Into Primary Care

Presents the justification and advantages of providing mental health services in primary care. Provides advice on how to implement and scale-up primary care for mental health, and describes how a range of health systems have successfully undertaken this transformation. Part 1 provides the context for understanding primary care for mental health within the broader health care system. Part 2 explains how to successfully integrate mental health into primary care and highlights 10 common principles which are central to this effort. It also presents 12 detailed case examples to illustrate how a range of health systems have undertaken this transformation. Annex 1 provides information about the skills and competencies that are required to effectively assess, diagnose, treat, support and refer people with mental disorders.

Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s).

Defines an approach to mental healthcare focused on achieving international equity in coverage, options and outcomes.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

This timely new edition of Integrated Behavioral Health in Primary Care brings the reader up to speed with the changing aspects of primary care service delivery in response to the Patient-Centered Medical Home (PCMH), the Triple-Aim health approach, and the Patient Protection and Affordable Care Act. Drawing on research evidence and years of experience, the authors provide practical information and guidance for behavioral health care practitioners who wish to work more effectively in the fast-paced setting of primary care, and provide detailed advice for addressing common health problems such as generalized anxiety disorder, depression, weight issues, sleep problems, cardiovascular disorders, pain disorders, sexual problems, and more. New to this edition are chapters on population health and the PCMH; children, adolescents, and parenting; couples; managing suicide risk; and shared medical appointments. This paperback edition was previously published in hardcover in 2017.

“In this 2nd edition, Robinson and Reiter give us an updated blueprint for full integration of behavioral health and primary care in practice. They review the compelling rationale, but their real contribution is telling us exactly HOW to think about it and how to do it. This latest book is a must for anyone interested in population health and the nuts and bolts of full integration through using the Primary Care Behavioral Health Consultation model.” Susan H McDaniel Ph.D., 2016 President, American Psychological Association Professor, University of Rochester Medical Center The best-selling guide to integrating behavioral health services into primary care is now updated, expanded and better than ever! Integration is exploding in growth, and it is moving inexorably toward the model outlined here. To keep pace, this revised text is a must for primary care clinicians and administrators. It is also essential reading for graduate classes in a variety of disciplines, including social work, psychology, and medicine. This updated edition includes: · A refined presentation of the Primary Care Behavioral Health (PCBH) model · The latest terms, trends and innovations in primary care · Comprehensive strategies and resource lists for hiring and training new Behavioral Health Consultants (BHC) · Step-by-step guidance for implementing the PCBH model · A plethora of evolved practice tools, including new Core Competency Tools for BHCs and primary care providers · Sample interventions for behaviorally influenced problems · The use of “Third Wave” behavior therapies in primary care · Detailed program evaluation instructions and tools · The latest on financing integrated care · An entire chapter on understanding and addressing the prescription drug abuse epidemic · Experienced guidance on ethical issues in the PCBH model · Improved patient education handouts With all of the changes in health care, the potential for the Primary Care Behavioral Health (PCBH) model to improve primary care—and the health of the population—is greater than ever. This book should be the first read for anyone interested in realizing the potential of integration.

Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.

The Primary Care Behavioral Health (PCBH) model is emerging as the future of integration between mental health and primary care services. The first book to detail the model, Behavioral Consultation and Primary Care explains in hands-on terms how to achieve truly integrated care. From starting up a new PCBH service to evaluating its outcome, clinicians and medical administrators alike will value in this up-to-the-minute resource.