Implementation of Behavioral Health Integration in Small Primary Care Settings: Lessons Learned and Future Directions

Primary care practices are in great need of practical guidance on the steps they can take to build behavioral health integration (BHI) capacities, particularly for smaller practice settings with fewer resources. 11 small primary care sites (≤ 5 providers) throughout New York State utilized a continu...

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Bibliographic Details
Published in:Community mental health journal 2022, Vol.58 (1), p.136-144
Main Authors: Goldman, Matthew L., Smali, Ekaterina, Richkin, Talia, Pincus, Harold Alan, Chung, Henry
Format: Article
Language:English
Subjects:
Community and Environmental Psychology
Focus Groups
Health behavior
Health information
Health services
Humans
Integrated care
Medical practices
Medicine
Medicine & Public Health
Mental health
Mental health care
New York
Original Paper
Policy making
Primary care
Primary Health Care
Psychiatry
Site visits
Surveys and Questionnaires
Technical assistance
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Summary:Primary care practices are in great need of practical guidance on the steps they can take to build behavioral health integration (BHI) capacities, particularly for smaller practice settings with fewer resources. 11 small primary care sites (≤ 5 providers) throughout New York State utilized a continuum framework of core components of BHI in combination with technical assistance. Surveys were collected at baseline, 6-months, and 12-months. Semi-structured interviews and focus groups were conducted during site visits, and a stakeholder roundtable was facilitated to address broader themes. Data were analyzed using qualitative thematic analysis. Practices reported successful engagement with the framework and actively participated in planning and advancing BHI operations. Greater success was observed in practices with existing on-site BHI services, identified champions for BHI, early and sustained training and involvement of providers and administrators, use of collaborative agreements with external behavioral health providers, and capacity to successfully receive reimbursements for BHI services. Advancing health information technologies was a challenge across sites. Financing and policy factors were viewed as critically important to advance integration efforts. The pilot of a continuum framework offers lessons for primary care practices and policymakers to advance integrated BH care.
ISSN:0010-3853
1573-2789
DOI:10.1007/s10597-021-00802-z