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The role of mental and behavioral health in the application of the patient-centered medical home in the Department of Veterans Affairs

  • Practice and Public Health Policy
  • Published:
Translational Behavioral Medicine

ABSTRACT

The patient-centered medical home, which is termed the Patient Aligned Care Team (PACT) in the Department of Veterans Affairs (VA), is a transformational initiative with mental and behavioral health as integral components. Funding has been provided to VA medical facilities to assist with the transformation and process redesign of primary care into interdisciplinary teams focused on increased access, Veteran-centered care, and active incorporation of collaborative expertise from specialists within primary care. Primary care clinics are not simple machines that change by merely replacing parts or colocating additional resources. Rather, they are complex systems with a relationship infrastructure among members of the team that is critically important to the change process. Mental health professionals are integral, mandated members of the PACTs providing needed mental and behavioral health care to Veterans as an integrated component of primary care. They also work to catalyze a quality improvement process that encourages collaboration, innovation, and adoption of best practices that promote transformation based on patient-centered principles of care. The purpose of this article is to describe the evolution of VA primary care settings toward interdisciplinary teams that provide patient-centered care in collaboration with Primary Care–Mental Health Integration providers and Health Promotion Disease Prevention team members.

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Author information

Authors and Affiliations

  1. National Integrated Care Coordinator, Office of Mental Health Operations, VA Central Office, 5441 Babcock Road, Suite 300, San Antonio, TX, 78240, USA

    Lisa K. Kearney PhD

  2. National Medical Director, Primary Care-Mental Health Integration Office, VA Central Office—Office of Primary Care, 2215 Fuller Road, Ann Arbor, MI, 48105, USA

    Edward P. Post MD, PhD

  3. Chief Consultant, Office of Mental Health Services, VA Central Office, 810 Vermont Ave., NW, Washington, DC, 20420, USA

    Antonette Zeiss PhD

  4. Associate Chief Consultant for Preventive Medicine, VHA National Center for Health Promotion and Disease Prevention, 3022 Croasdaile Drive, Suite 200, Durham, NC, 27705, USA

    Michael G. Goldstein MD

  5. National Program Manager for Health Behavior, VHA National Center for Health Promotion and Disease Prevention, 3022 Croasdaile Drive, Suite 200, Durham, NC, 27705, USA

    Margaret Dundon PhD

Authors
  1. Lisa K. Kearney PhD
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  2. Edward P. Post MD, PhD
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  3. Antonette Zeiss PhD
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  4. Michael G. Goldstein MD
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  5. Margaret Dundon PhD
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Corresponding author

Correspondence to Lisa K. Kearney PhD.

Additional information

Implications

Practice: The incorporation of mental and behavioral health providers as change agents into primary care settings is critical to fully implementing the spirit of the patient-centered medical home, namely, the application of interdisciplinary approaches that address the full spectrum of health concerns.

Policy: Medical home resources should focus on the development and continuous improvement of collaborative interventions that broadly incorporate biopsychosocial needs and apply methods of registry-based care that track and optimize health and health conditions.

Research: Further research is needed in the evaluation of interdisciplinary clinical processes, as well as clinical outcomes, from care delivered through patient-centered medical homes.

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Kearney, L.K., Post, E.P., Zeiss, A. et al. The role of mental and behavioral health in the application of the patient-centered medical home in the Department of Veterans Affairs. Behav. Med. Pract. Policy Res. 1, 624–628 (2011). https://doi.org/10.1007/s13142-011-0093-4

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  • DOI: https://doi.org/10.1007/s13142-011-0093-4

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