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Building Behavioral Health Homes: Clinician and Staff Perspectives on Creating Integrated Care Teams

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A Correction to this article was published on 12 September 2018

This article has been updated

Abstract

Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings. Clinicians and staff from ten agencies engaged in the Behavioral Health Home Learning Collaborative participated in qualitative interviews exploring local definitions of “behavioral health home” and initial barriers and facilitators to integration. Facilitators included clear staff roles, flexible scheduling, and interdisciplinary huddles and staff trainings. Challenges included workforce, limited use of electronic health records, and differing professional cultures. Participants advocated for new workflows and payment structures to accommodate scheduling demands and holistic case management.

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Change history

  • 12 September 2018

    The Publisher regrets that due to a malfunction in production, there are duplications and errors and rogue addresses in the author affiliations of the published article. The correct author affiliations are listed below.

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Acknowledgements

CMS Adult Medicaid Quality Grant Program. This document was developed using data from a project funded by the grant program outlined under the Catalog of Federal Domestic Assistance Number 93.609 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy or views of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government.

The authors acknowledge ongoing program support from Beth Sommers, MPH, CPHQ, Oregon Rural Practice-based Research Network; Rita Moore, PhD, Oregon Health Authority; and Charles Gallia, PhD, Oregon Health Authority. We thank the ten participating Oregon Behavioral Health Homes for their participation in the learning collaborative and associated research.

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Authors and Affiliations

  1. Oregon Rural Practice-based Research Network (ORPRN), 3181 SW Sam Jackson Park Rd, Mail Code L 222, Portland, OR, 97239, USA

    Tracy Anastas BA, Elizabeth Needham Waddell MA, PhD, Sonya Howk MPA, HA, Mark Remiker MA, CCRP & L. J. Fagnan MD

  2. Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA

    Tracy Anastas BA, Elizabeth Needham Waddell MA, PhD, Sonya Howk MPA, HA, Mark Remiker MA, CCRP, Gretchen Horton-Dunbar BA & L. J. Fagnan MD

  3. OHSU-PSU School of Public Health, 184 Parkmill Building, 1633 SW Park Avenue, Portland, OR, 97201, USA

    Elizabeth Needham Waddell MA, PhD & Gretchen Horton-Dunbar BA

Authors
  1. Tracy Anastas BA
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  2. Elizabeth Needham Waddell MA, PhD
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  3. Sonya Howk MPA, HA
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  4. Mark Remiker MA, CCRP
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  5. Gretchen Horton-Dunbar BA
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  6. L. J. Fagnan MD
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Corresponding author

Correspondence to Elizabeth Needham Waddell MA, PhD.

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Anastas, T., Waddell, E.N., Howk, S. et al. Building Behavioral Health Homes: Clinician and Staff Perspectives on Creating Integrated Care Teams. J Behav Health Serv Res 46, 475–486 (2019). https://doi.org/10.1007/s11414-018-9622-y

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  • DOI: https://doi.org/10.1007/s11414-018-9622-y

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