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

  • Bethany M. KwanEmail author
  • Donald E. NeaseJr.


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.


Mental Health Behavioral Health Veteran Health Administration Collaborative Care Integrate Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Family MedicineUniversity of Colorado DenverAuroraUSA

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