Definition
Behavioral health and primary care integration has been defined as patient-centered care that addresses mental health and substance use conditions, health behaviors, life stressors, and stress-related physical symptoms, provided by a team of primary care and behavioral health clinicians.[i] Addressing whole person health requires applying this concept of integration both within and outside of the traditional healthcare system. Therefore, behavioral health integration pertains to (1) the healthcare sector; and (2) cross sector collaborations between the healthcare sector and social services, employers, schools, and communities.
Ultimately, the underlying principle of behavioral health integration is that physical, behavioral, and social health are inextricably intertwined. Fragmented systems of care create barriers to achieving optimal whole person health. Integration of care is a solution to fragmentation. Understanding the physical, behavioral, and social determinants of health, and their relationship to one another, exposes the root causes of many health disparities. Policies advancing integration support sustainable change to achieve more equitable health outcomes.
[1] Peek, C.J. & the National Integration Academy Council. (2013). Lexicon for Behavioral Health and Primary Care Integration: Concepts and Definitions Developed by Expert Consensus. AHRQ Publication No. 13-IP001-EF. Rockville, MD: Agency for Healthcare Research and Quality.
Principles
- People present with behavioral health concerns in multiple settings; they should receive the care they need at the place and time that is right for them.
- The diverse causes and consequences of behavioral health conditions call for coordinated, cohesive action within healthcare, and between healthcare and social services, employers, schools, and communities.
- Many behavioral health conditions and complications can be prevented.
- There is a gap between what is known to improve whole person health and what is being done.
- Whole person care is best supported by integrated systems for training, payment, and care delivery addressing physical, behavioral, and social health together.
- To advance health equity and improve population health, the structural root causes of inequitable access to social resources must be addressed, including stigma and discrimination.
- One size does not fit all. Strategies will best meet needs when they are locally determined or adapted. Policies should ensure flexibility for tailored and targeted approaches.