Nearly 60 million U.S. adults live with a behavioral health condition that requires medical assistance, yet stigma, socioeconomic factors, and navigational challenges caused by a fragmented healthcare system are all barriers to care. However, there is a systemic change that could dynamically increase support for those who need it most: The integration of behavioral health into primary care.
Integrating behavioral health into primary care is not merely an enhancement of services but a necessary evolution in our healthcare system that provides more comprehensive, timely, and equitable whole-person care. Behavioral health integration with primary care has the ability to improve depression symptoms, improve treatment adherence, lower health care costs, and decrease physician stress.
Behavioral health integration helps deliver on the promise of whole-person care by adding behavioral health providers as members of primary care teams, enabling coordinated, patient-centered care. Primary care physicians (PCPs) are well-positioned to identify behavioral health needs. In an integrated setting, PCPs are then able to directly connect patients to behavioral health services—often within the primary care clinic—to monitor patients’ progress and help connect patients to additional resources as needed. This enhanced level of coordination means patients no longer have to navigate a complex, fragmented system on their own to access behavioral health services. It also supports true patient-centered, team-based care where providers can work together towards a shared set of health goals. Well-known examples of this integrated approach include the Collaborative Care and Primary Care Behavioral Health models.
Approximately 80% of people with a behavioral health condition will visit a PCP or other primary care provider at least once a year, underscoring the importance of enhancing access to behavioral health services in a primary care setting. Integration helps promote a better understanding and de-stigmatization of behavioral health issues. Integrating behavioral health into routine healthcare visits with a trusted provider can help normalize behavioral health care for patients who might not have otherwise sought treatment.
Behavioral health integration into primary care additionally recognizes and honors the connection between physical and behavioral health. Research shows that patients with chronic health conditions, such as diabetes and heart disease, have a high prevalence of behavioral health conditions, and addressing behavioral health, in turn, helps improve their chronic health condition.
Industrywide, significant systemic barriers still hinder the integration of behavioral health into primary care settings. Policymakers, health plans, providers, and other stakeholders have the opportunity to work together to address these barriers and ensure that the necessary financing, technical infrastructure, and workforce are in place. For instance, health plans can work with provider groups to support implementation and can help increase member access through actions like eliminating co-insurance for integrated behavioral health services. Meanwhile, broader industry collaboration and policy can play a key role in laying the groundwork for the scaling and sustainability of behavioral health integration.
The integration of behavioral health into primary care holds the potential to advance our approach to health and wellness. It would shift the entire healthcare system towards a more compassionate, effective, and patient-centered approach. By ensuring that behavioral health is an integral part of primary care, we would lay the foundation for a healthier, more resilient society where comprehensive care is not just an ideal but a reality.
Jennifer Christian-Herman, PhD, is Vice President of Blue Shield of California’s Clinical Strategy and Programs. Brian Sandoval, PsyD, is Clinical Advisor at Collaborative Family Healthcare Association.
