ACP offers 6 strategies for integrating behavioral health, primary care

Behavioral health care should be integrated into the primary care setting and used as a “springboard for addressing both physical and behavioral health care,” ACP announced in a position paper that offered 6 strategies to do so.

Behavioral health encompasses mental health, substance abuse, stress-related physical symptoms, and other health-behavior changes, stated the position paper, which appeared in the June 30 Annals of Internal Medicine. Common behaviors such as living a sedentary lifestyle, using tobacco, eating inappropriately, and becoming socially isolated directly relate to overall health and mortality, according to the paper. In fact, “mental and substance use disorders alone have been estimated to surpass all physical diseases as a major cause of disability worldwide by 2020,” the paper stated.

However, “behavioral and physical health care providers have a long history of operating in different care silos,” according to the policy paper. ACP's paper details 6 strategies and recommendations for integrating behavioral health care into primary care offices.

1. 1. ACP supports the integration of behavioral health and primary care and encourages its members to address behavioral health issues as much as possible. This recommendation is consistent with the concept of whole-person care and the intermingling of physical and behavioral health conditions.
2. 2. ACP recommends that public and private health insurance payers, policymakers, and primary care and behavioral health professionals work to remove payment barriers that stand in the way of integrated care. Evidence shows that integrating behavioral health and primary care leads to improved mental health outcomes, physical health, and quality of life—not to mention lower costs, according to the paper.
3. 3. The College also recommends that federal and state governments, insurance regulators, payers, and other stakeholders address behavioral health insurance coverage gaps that are barriers to integrated care.
4. 4. As the current literature is limited, ACP supports increased research to define the most effective approaches to care integration. Research should focus on the effectiveness of various integration models—particularly the patient-centered medical home model—as well as the diagnostic and treatment interventions most appropriate for use in these models.
5. 5. ACP encourages efforts by federal and state governments, relevant training programs, and continuing education providers to ensure an adequate workforce to support care integration. Behavioral health professionals and primary care providers will need cross-discipline training in order to integrate their respective specialties.
6. 6. ACP's final recommendation addresses the negative stigma associated with behavioral health issues. The College recommends that all relevant stakeholders initiate programs to reduce the negative perceptions held by the general population and many clinicians.