Monday, February 15, 2010

Behavioral Health Care in a Primary Care Setting?!

This seems like a genius idea. How great would it be to receive comprehensive care during a visit to your primary care doctor? Not only would your body receive a wellness exam, but your head, too! What if you could develop a relationship with an on-site behavioral health therapist who you could talk to you about your fears about medical procedures or who could help you create lifestyle changes such as improving diet or exercise?

Three years ago, the Health Federation of Philadelphia started such an initiative to promote the integration of behavioral health into primary care settings. The Federation works with community health centers that serve uninsured and under-insured in Philadelphia. Details about this initiative are featured in this month's edition of the online Philadelphia Social Innovations Journal. The article highlights the development of this model of care, its implementation in the Philadelphia community health centers, the process of creating a reimbursement mechanism, and indicators of success. By all measures this initiative has been successful. Conservative estimates suggest that this model saved 3.7 million dollars in 2008. (The article details the formula used to establish this estimate.) In addition, the patients reported they were helped by the services and they would recommend the service to a friend or family member.

Given these results, I wonder, why are we (i.e., society) not investing in clinics that integrate behavioral and physical health? What are your thoughts about integrating behavioral health into a primary care setting?

posted by Lisa

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  1. Great post and great idea.

    I think any type of long-term wellness initiative is hard to implement. And with the benefits of behavioral health being less immediately apparent, it's probably a hard sell for most primary care offices.

    What a shame though, you'd think studies like the one mentioned in this post would get more press and traction to stir-up some change!

    Great find, Lisa!

  2. I have just begun work in a primary care setting, and I've found the physicians and PAs are hungry for a place to refer or someone with whom to discuss many of their patients. Most of my referrals are for anxiety and depression, as well as suboxone patients, but the "chest pain" and other somatic symptoms are also catching on. I hope to add more wellness activities as I increase my hours there.