Integrated behavioral health care is an emerging model of health care in which medical and mental health providers work together to treat an individual’s mental or behavioral disorders concurrently with any physical health challenges that he or she may be facing. This type of collaboration ensures that no symptoms are left unaddressed, while at the same time treating the individual in a highly efficient and cost-effective manner.
While an increasing number of facilities exist in which providers are located at the same site, this is not a requirement for integrated behavioral health. All that is needed is open communication and shared access to patient files.
What Is Integrated Behavioral Health?
According to the Lexicon for Behavioral Health and Primary Care Integration compiled by the Agency for Healthcare and Research Quality, integrated behavioral health is defined as
[a] practice team of primary care and behavioral health clinicians working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population.
Integrated behavioral health is a patient-centered approach to care, treating the whole person rather than focusing on each disorder or medical issue separately. In this way, treatment plans are tailored specifically to each individual patient rather than being generalized for the disorder.
Collaboration among providers minimizes the risk of symptoms being misdiagnosed and can save the patient time and money by limiting the need to shuttle back and forth and be the go-between for his or her providers. Integrated behavioral health also limits the risk of miscommunication among providers due to misunderstanding on the part of the patient.
Why Is Integrated Behavioral Health Important?
Chronic illnesses such as obesity, hypertension, heart and lung disease, and diabetes can be aggravated by habits stemming from behavioral, mental health, or substance use disorders. Individuals who are in treatment for their behavioral or mental health disorders may be unable to find appropriate medical care for their underlying medical issues, leading to deteriorating physical health.
On the other hand, many people with behavioral or mental health disorders will first seek treatment with their primary care physician rather than a dedicated mental health professional. As such, the primary care physician is in a position to become a gateway to necessary services, but often lacks the training required to identify the specific services needed. Integrated behavioral health care bridges the gap between providers so that patients can get adequate treatment for any and all problems they may be facing.
According to the SAMHSA-HRSA Center for Integrated Health Solutions:
Integrating mental health, substance abuse, and primary care services produces the best outcomes and proves the most effective approach to caring for people with multiple healthcare needs.
Increased collaboration among providers lessens the risk of inadvertently mixing incompatible medications as well as making certain that all symptoms receive the attention required so that nothing “falls through the cracks.” The patient is also relieved of the responsibility for trying to determine whether specific symptoms require the attention of a mental health provider or a medical care provider, ensuring that symptoms receive the correct treatment.
How is Integrated Behavioral Health Practiced?
Integrated behavioral health exists along a continuum, and can be utilized to varying degrees depending on the needs of the patient and the resources available to care providers. The CIH has put together a framework for levels of integrated care. Level 1 is the model that is most common for the typical patient: communication among providers is limited, and each provider practices out of a discrete location.
In this level, the patient bears most of the responsibility for sharing information among care providers, increasing the risk for miscommunication or omission of crucial details. Interaction between prescribed medication is a higher probability in this model, as the individual care providers may not be aware of all of the patient’s prescriptions.
Increased provider collaboration is described with five more levels, culminating in Level 6, “Full Collaboration in a Transformed/Merged Practice.” At this level, providers practice within the same facility and share a common vision of care for their patients. All patients in the practice receive the same level of integrated care regardless of their individual needs.
Most integrated behavioral health programs currently fall somewhere in the intermediate levels. Providers may collaborate via telephone and email, but never meet face-to-face. Electronic patient files housed online make this type of collaboration much more convenient than hard copy files. Some providers may operate from a shared facility but still work largely independent of one another, collaborating only on specific patients.
These levels of integration are more beneficial to the patient than Level 1, but are not as encompassing and thorough as Level 6. The higher the level of integration, the more benefits the patient can reap and the more likely it is that he or she will receive complete, appropriate treatment for all of his or her symptoms.
Summing Up
As integrated behavioral health becomes more widespread as a practice model, more patients can see an improvement to their overall health. As a result, we can hopefully see a decrease in the risk of premature death in patients with co-occurring mental and physical health disorders as well as an overall decrease in the cost of health care.
Do you have any experience with integrated behavioral health? Do you feel that it’s a beneficial treatment model? Let us know in the comments. If this article has been helpful to you, don’t forget to share on Facebook and Twitter.
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