Integrating Behavioral Health into Primary Care Models in the United States

Healthcare integration models have been increasingly growing in the United States to address the various comorbidities of mental health challenges patients face daily. At least 40% of patients in primary care settings require behavioral health services, and this figure rises even higher for those with chronic comorbid conditions (Crocker et al., 2021; Ramanuj et al., 2019). Providers can neglect behavioral health symptoms associated with a medical condition because of time constraints, workload burdens, inadequate training, and physician burnout (Kroenke & Unutzer, 2017; Patel et al., 2018). Consequently, patients may have less success coping with their symptoms, experience poor health outcomes, experience mental health stigmas, and perhaps fail to address their behavioral health challenges during patient visits. Integrating behavioral health into primary care models can help alleviate this problem by providing team-based care, using team-based care to improve patient experience, and managing chronic conditions to improve outcomes for patients and their families, supporting the quadruple aim. (Christian et al., 2018; Crocker, 2021; Hunter et al., 2018).

Multiple chronic illnesses affect at least 77 million Americans (Bhatt & Bathija, 2018). Considering that 71% of total healthcare spending in the United States is consumed by the cost of caring for these people, the United States consumes a considerable amount of healthcare dollars (Bhatt & Bathija, 2018). By improving primary-care services, reducing healthcare costs, increasing access to services, and improving patient outcomes, integrated health care has proven to effectively address multifaceted comorbid health challenges faced by primary-care patients (Hunter et al., 2018; Kroenke & Unutzer, 2017; Jolly et al., 2016). Even though there is a wealth of literature on integrated health care, there are significant gaps in measuring the clinical level of integration, effects of PCBH on patients, implementation outcomes, and efforts in primary care settings that can be used to understand patient outcomes and informed treatment decision making (Duncan et al.,2021; Hunter et al., 2018; Macchi et al., 2016; Ramanuj et al., 2019).

Literature Review

Primary Care Behavioral Health (PCBH) Model
Managing behavioral health services in primary care facilities and integrating them with primary care is achievable with the behavioral health model. Recent years have seen a dramatic increase in interest in integrating behavioral health services into primary care settings. For example, primary care behavioral health (PCBH) is linked to improved behavioral health measures in primary care, enhanced medical professional mental health understanding, promotes healthier outcomes, and patient’s overall well-being by increasing access to behavioral health care and improving access to services (Hunter et al., 2017; Jolly et al., 2018; Reiter et al., 2018). The goal of the PCBH model initiative is to improve primary care services by nurturing a team-based environment that can deliver effective, holistic care to a large percentage of the population delivering high volume brief interventions as an alternative to traditional independent psychotherapy and works toward improving population health outcomes.

Q 1: Will the clinic level of integration (DV) significantly improve between pre-and post-measurement following PCBH implementation (IV)?

Q2: Will the patient health outcomes (DV) significantly improve following access to behavioral health services (IV) in primary care?