The Primary Care Behavioral Health Model: Applications to Prevention, Acute Care and Chronic Condition Management
Research findings consistently suggest that most people receive behavioral health (BH) services in the primary care setting. The annual rate of onset of mental and addictive disorders hovers in the vicinity of 27%, and the vast majority of those afflicted by these problems seek care from primary care providers (PCPs). People present to primary care for assistance with a myriad of other BH problems, such as nicotine addiction, obesity, chronic pain, medical nonadherence, insomnia and learning problems. For most problems that challenge the quality of life for citizens of any age, primary care is the beginning and ending point of care. It is unfortunate that most PCPs need to see 20–35 patients a day to stay in business, as the time constraints alone make it nearly impossible for them to detect and treat the BH needs of the patients filling their waiting rooms. Limited training and a growing lack of access to BH providers for consultation further frustrate the typical PCP’s efforts to address the BH needs. When not addressed effectively, BH problems contribute to higher medical costs, as well as poorer medical, functional and behavioral outcomes. Given this dire situation, primary care systems, both large and small, are exploring collaborative care options.
KeywordsBehavioral Health Addictive Disorder Panic Symptom Primary Care System Behavioral Health Provider
Unable to display preview. Download preview PDF.
- 3.Reiger D, Narrow W, Rae D, Manderschied R, Locke B, Goodwin F. The de facto US mental and addictive disorders service system: Epidemiologic Catchment Area prospective 1 year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993;50:85–94.Google Scholar
- 8.Robinson P, Reiter J. Behavioral Consultation in Primary Care: A Guide to Integrating Services. New York: Springer; 2007.Google Scholar
- 9.Strosahl K. The integration of primary care and behavioral health: type II change in the era of managed care. In: Cummings N, O’Donohoe W, Hayes S, Follette V, eds. Integrated Behavioral Healthcare: Positioning Mental Health Practice with Medical/Surgical Practice. New York: Academic Press; 2001:45–70.Google Scholar
- 10.Peek CJ. Bringing other cultures together: harmonizing the clinical, operational and financial perspectives of health care. In: Patterson J, Peek C, Heinrich R, Bischoff R, Scherger J, eds. Mental Health Professionals in Medical Settings: A Primer. New York: Norton.Google Scholar
- 12.Strosahl K. Building primary care behavioral health systems that work: a compass and a horizon. In: Cummings N, Cummings J, Johnson J, eds. Behavioral Health in Primary Care: A Guide for Clinical Integration. Madison: Psychosocial Press; 1997:37–68.Google Scholar
- 13.Strosahl K. Integration of primary care and behavioral health services: the primary mental health care model. In: Blount A, ed. Integrative Primary Care: the future of medical and mental health collaboration. New York: Norton;1998:43–66.Google Scholar
- 14.Hayes S, Strosahl K, Wilson K. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: The Guilford Press; 1998.Google Scholar
- 15.Parkerson G. User’s Guide for the Duke Health Profile (Duke). 1996. Manual available from the author at: Department of Community and Family Medicine, Box 3886, Duke University Medical Center, Durham, NC 27710, USA.Google Scholar
- 16.Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s healthy days measures—population tracking of perceived physical and mental health over time. health quality life outcomes. 2003. Available at: http://www.hqlo.com/content/1/1/37. Accessed February 12, 2006.