Annals of Internal Medicine · 2015 · 193 citations · 33 references
Family MedicineSubstance UseClinical Health PsychologyMental HealthHealth PsychologyMental Health InterventionSubstance Use DisordersHealthcare DeliveryPrimary CareBehavioral Health CareAddiction MedicineHealth Services ResearchHealth SciencesMental Health ServicesIntegrated CareHealth PolicyPsychiatryAdult Behavioral HealthPrimary Health CareNursingHealth SystemsSubstance AbuseCommunity Mental HealthMental Health NursingAmerican CollegeAdult Mental HealthAddiction Health Service ResearchBehavioral HealthMedicine
Behavioral health care encompasses mental health, substance abuse, health behavior change, life stresses, and stress‑related physical symptoms, and mental and substance use disorders are projected to become the leading cause of worldwide disability by 2020, underscoring the need for health systems to address these conditions. This position paper focuses on better integration of behavioral health into primary care. The paper reviews the current state of behavioral health conditions, discusses barriers and arguments for integration, evaluates integrated care delivery models, and proposes policy recommendations for the American College of Physicians. Recently, there has been a call for using the primary care delivery platform and the patient‑centered medical home model to effectively address these conditions.
Behavioral health care includes care for patients around mental health and substance abuse conditions, health behavior change, life stresses and crises, and stress-related physical symptoms. Mental and substance use disorders alone are estimated to surpass all physical diseases as a major cause of worldwide disability by 2020. The literature recognizes the importance of the health care system effectively addressing behavioral health conditions. Recently, there has been a call for the use of the primary care delivery platform and the related patient-centered medical home model to effectively address these conditions. This position paper focuses on the issue of better integration of behavioral health into the primary care setting. It provides an environmental scan of the current state of conditions included in the concept of behavioral health and examines the arguments for and barriers to increased integration into primary care. It also examines various approaches of integrated care delivery and offers a series of policy recommendations that are based on the reviewed information and evidence to inform the actions of the American College of Physicians and its members regarding advocacy, research, and practice.
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