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What is integrated behavioral care and how do you know if it’s a good fit?

Simply put, it’s a service delivery system that coordinates behavioral care with medical care –reattaching the head to the body. The Hogg Foundation For Mental Health describes it in more detail:

“In this team-based model, medical and mental health providers partner to facilitate the detection, treatment, and follow-up of psychiatric disorders in the primary care setting. It is an appropriate model for treating mild to moderate psychiatric disorders and for maintaining the treatment of severe psychiatric disorders (e.g., bipolar disorder, schizophrenia) that have been stabilized.”

Though this definition confines service delivery to primary care settings, in practice, the venue can vary. The important factor is not where the services are delivered, but how: There must be close coordination and collaboration between behavioral health and medical service providers resulting, ideally, in a seamless continuum of care for the clients. Alexander Blount, a national expert in this field, put it this way: “Integrated primary care is a service that combines medical and behavioral health services to more fully address the spectrum of problems that patients bring to their primary medical care providers. It allows patients to feel that, for almost any problem, they have come to the right place.”

The World Health Organization (WHO) offered a global perspective to integrated care with its report “Integrating Mental Health into Primary Care”, exploring worldwide initiatives. Among the report’s key points is the conclusion that “integrating mental health services into primary care is the most viable way of closing the treatment gap and ensuring that people get the mental health treatment they need.”  The report describes best practices in Argentina, Australia, Brazil, India and several other countries and synthesizes the ten principles of integrated care researchers extracted from their findings:

  • Policy and plans need to incorporate primary care for mental health.
  • Advocacy is required to shift attitudes and behavior.
  • Adequate mental health training of primary care workers is required.
  • Primary care tasks must be limited and doable.
  • Specialist mental health professionals and facilities must be available to support primary care.
  • Patients must have access to essential psychotropic medication in primary care.
  • Integration is a process, not an event.
  • A mental health service coordinator is crucial.
  • Collaboration with other government nonhealth sectors, nongovernmental organizations, village and community health workers and volunteers is required.
  • Financial and human resources are needed.