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The State of the Evidence for Integrated Behavioral Health in Primary Care

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Abstract

Integrated behavioral health care is a complex, multifaceted healthcare delivery approach that is geared towards addressing mental and behavioral health concerns in primary care. There are a number of different models for integrated behavioral health care, with components that can be conceptualized as structures of care, processes of care, or principles of care. Common models include the IMPACT model (care management for depression), the three-component model (care management, enhanced mental health support, and a prepared practice), and the primary mental health care model of colocated integrated behavioral health care (on-site mental health specialists who collaborate with primary care providers), among others. Meta-analysis has shown that integrated behavioral health care improves health outcomes, although the extant evidence primarily pertains to depression. It is not well known which components of integrated behavioral health care are either necessary or sufficient for improving outcomes. There are many evidence gaps in integrated behavioral health care, including implementation and dissemination and the effects of integrated behavioral health care on disease contexts other than depression, behavioral medicine (e.g., lifestyle change in primary care), diverse populations, and cost and sustainability outcomes. Multiple methodologies should be deployed to address these gaps, including quasi-experimental, mixed methods (quantitative and qualitative), and observational designs.

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Acknowledgments

The authors wish to acknowledge the expertise of our many esteemed colleagues and collaborators who practice, study, and promote integrated behavioral health care in the “real world” every day. Their experiences and expertise informed the direction and content of this chapter.

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  1. Department of Family Medicine, University of Colorado Denver, Aurora, CO, USA

    Bethany M. Kwan Ph.D., MSPH & Donald E. Nease Jr. M.D.

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  1. Bethany M. Kwan Ph.D., MSPH
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  2. Donald E. Nease Jr. M.D.
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Correspondence to Bethany M. Kwan Ph.D., MSPH .

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  1. , Northwestern Family Medicine Residency, Erie Family Health Center, W. North Avenue 2570, Chicago, 60647, Illinois, USA

    Mary R. Talen

  2. , Family Health Center, Concord Hospital, Pleasant St. 250, Concord, 03301, New Hampshire, USA

    Aimee Burke Valeras

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Kwan, B.M., Nease, D.E. (2013). The State of the Evidence for Integrated Behavioral Health in Primary Care. In: Talen, M., Burke Valeras, A. (eds) Integrated Behavioral Health in Primary Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6889-9_5

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