This book provides an evidence-based guide for primary care physicians seeking to integrate behavioral health into their practice. This is grounded in the underlying notion that integrating behavioral health and primary care is not an adjustment to practice but a reconstruction of how primary health care is defined and delivered. While some aspects (billing and financing) will be specific to the policy context in the United States, much of the book will contain universal lessons for an approach to integration from a primary care perspective that may be relevant across the globe. This guide is organized to follow a comprehensive approach, derived from lessons learned by early adopters of integration. Dividing the book in this manner creates a unique and natural flow from the “why” of integrating care to a step-by-step approach to achieve integration in a practice. The book includes the case for why integrating behavioral health is important; what integration looks like in practice; and how to transform a practice and grow a team of clinicians to work together to address mental, emotional, and behavioral problems. Each chapter starts with a short preamble to introduce the stage of integration. Each chapter and subchapter would end with a summary box of key messages and a short list of resources (articles, websites, etc) for further information for each topic. Where relevant, chapters additionally include a brief section on application for specific populations (pediatrics, geriatrics, etc). This is an ideal guide for primary care physicians and their medical and administrative teams interested in integrating behavioral health in their practice.

Contributed by experts who’ve developed integrative healthcare initiatives with strengths in the areas of policy and principles, organizational systems, or clinical practice. These contributors will illustrate the concepts and describe the nuts and bolts of their integration initiatives. In the conclusion of each section, the editors will construct a template to systematically evaluate these essential elements. This template will organize the information to help stakeholders compare and contrast the strengths, resources, limitations and challenges of how each model meets the vision of integrative healthcare. In the concluding section the information in the preceding sections connects to provide a coherent synopsis of the common themes and practices, from the macro to micro levels of care, which foster successful integration of the medical and psychosocial systems.

Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s).

Presents the justification and advantages of providing mental health services in primary care. Provides advice on how to implement and scale-up primary care for mental health, and describes how a range of health systems have successfully undertaken this transformation. Part 1 provides the context for understanding primary care for mental health within the broader health care system. Part 2 explains how to successfully integrate mental health into primary care and highlights 10 common principles which are central to this effort. It also presents 12 detailed case examples to illustrate how a range of health systems have undertaken this transformation. Annex 1 provides information about the skills and competencies that are required to effectively assess, diagnose, treat, support and refer people with mental disorders.

“In this 2nd edition, Robinson and Reiter give us an updated blueprint for full integration of behavioral health and primary care in practice. They review the compelling rationale, but their real contribution is telling us exactly HOW to think about it and how to do it. This latest book is a must for anyone interested in population health and the nuts and bolts of full integration through using the Primary Care Behavioral Health Consultation model.” Susan H McDaniel Ph.D., 2016 President, American Psychological Association Professor, University of Rochester Medical Center The best-selling guide to integrating behavioral health services into primary care is now updated, expanded and better than ever! Integration is exploding in growth, and it is moving inexorably toward the model outlined here. To keep pace, this revised text is a must for primary care clinicians and administrators. It is also essential reading for graduate classes in a variety of disciplines, including social work, psychology, and medicine. This updated edition includes: · A refined presentation of the Primary Care Behavioral Health (PCBH) model · The latest terms, trends and innovations in primary care · Comprehensive strategies and resource lists for hiring and training new Behavioral Health Consultants (BHC) · Step-by-step guidance for implementing the PCBH model · A plethora of evolved practice tools, including new Core Competency Tools for BHCs and primary care providers · Sample interventions for behaviorally influenced problems · The use of “Third Wave” behavior therapies in primary care · Detailed program evaluation instructions and tools · The latest on financing integrated care · An entire chapter on understanding and addressing the prescription drug abuse epidemic · Experienced guidance on ethical issues in the PCBH model · Improved patient education handouts With all of the changes in health care, the potential for the Primary Care Behavioral Health (PCBH) model to improve primary care—and the health of the population—is greater than ever. This book should be the first read for anyone interested in realizing the potential of integration.

Integrated care is receiving a lot of attention from clinicians, administrators, policy makers, and researchers. Given the current healthcare crises in the United States, where costs, quality, and access to care are of particular concern, many are looking for new and better ways of delivering behavioral health services. Integrating behavioral health into primary care medical settings has been shown to: (1) produce healthier patients; (2) produce medical savings; (3) produce higher patient satisfaction; (4) leverage the primary care physician’s time so that they can be more productive; and (5) increase physician satisfaction. For these reasons this is an emerging paradigm with a lot of interest and momentum. For example, the President’s New Freedom Commission on Mental Health has recently endorsed redesigning the mental health system so that much of this is integrated into primary care medicine.

Real-life examples provided by clinical staff who made the transition to collaborative care are woven into the text, providing insight into the goals of improving outcomes, patient satisfaction, and cost containment.

Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.

The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward. The book's features are both high-impact and user-friendly: The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.

This book provides a step-by-step guide to integrating early childhood behavioral health care into primary care with hands-on advice for creating, implementing, and evaluating programs. It discusses the unique advantages of pediatric primary care as a setting for mental health services from birth into the early school years, particularly for addressing parent/child stress and trauma issues. Contributors illustrate in depth how bringing behavioral health into pediatric services can engender care that is replicable and sustainable, not only cost-effective but also clinically effective. Guidelines and case examples from frontline practitioners highlight typical challenges and workable recommendations. Among the featured topics: • The fit between early intervention programs and primary care.• Staffing, workforce development, and funding issues.• On-the-job teamwork concerns, from time constraints to continuity of care.• Culturally competent care geared toward key child care issues.• Intervening with parents of young children in the integrated pediatric setting. Integrated Early Childhood Behavioral Health in Primary Care is an essential resource for clinicians/practitioners, graduate students, and researchers in child and school psychology, pediatrics, and social work.