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Behavioral and Mental Health Integration into Primary Care Practice

The COVID-19 pandemic, the opioid epidemic, extreme weather events, increased gun violence, and other local, national, and global political unrest have taken a devastating toll on mental health while mental health professionals are in short supply.  ACP is part of a coalition of eight leading societies (5 primary care societies, 2 psychiatric societies, and the AMA) established to cultivate effective and sustainable integration of behavioral and mental health care into primary care practices. 

Webinar: Integrating Behavioral Health into Primary Care

Matthew Press, MD, MSc, discusses the integration of behavioral health within the primary care setting and providing mental health care as an internal medicine physician with a specific focus on the Collaborative Care Model, which is an evidence-based, reimbursable, and efficient program in use across the country. (Recorded 6/26/2023, 48 min). Watch Now

BHI Collaborative

  •  – Eight leading societies (5 primary care societies, 2 psychiatric societies, led by the AMA) established the BHI Collaborative to cultivate effective and sustainable integration of behavioral and mental health care into primary care practices. (The member groups are: AMA, ACP, AAFP, AAP, ACOG, AOA, APA, and ASCAP.) 
    •  – The BHI Compendium is a tool to help physicians understand BHI and how to make it effective for your practice and patients. The goal is to provide accessible, detailed information on the steps required to integrate behavioral health care into your practice along with direct links to relevant resources for more specific information. 
    •  – The BHI Collaborative created this webinar series covering a variety of topics to help practices tackle different aspects of integrating behavioral health into primary care. 

Helpful BHI Resources

  •  – This psychopharmacology tool was created by Waco Family Medicine in consult with the Massachusetts General Hospital Psychiatry Academy. Also available in an smartphone app, the Waco Guide is intended to guide decisions regarding psychopharmaceutical treatment of common psychiatric conditions seen in adult and pediatric primary care (e.g., depression, anxiety, ADHD, substance use disorders, PTSD, eating disorders, etc.). 
  •  – This website from the University of Washington in Seattle offers a wealth of information to help practices integrate mental health services into primary care practice, including role-based tools, screening instruments, videos, patient materials, billing and coding guidance, registries, and implementation support.  
    •  - Seasoned coaches and experts answer questions and provide guidance regarding collaborative care, staff training, registry tools, and whatever implementation hurdles physician practices are encountering. These calls are open-ended and you can can call at any time during the hour. 
      • Implementation Office Hours – 3rd Thursday of each month (10 PT/11 MT/12 CT/1 ET) 
      • Finance Office Hours – 1st Wednesday of each month (9 PT/10 MT/11 CT/12 ET) 
    •  – This downloadable workbook can help practices model and estimate revenue and expenses for providing integrated behavioral health services (free with registration). 
  • - This website includes CME activities, safety planning, assessment toolkits, and training and other resources that you can use for your practice.

From the AMA

  • How-To Guides: 
  • Workflow Guides: 
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  •  – This module can help identify which model is best for your practice. 

Other Readings

  • From Annals of Internal Medicine: 
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  •  (Family Practice Management, May-June 2021) 
  •  (Economist, October 11, 2021) 

ACP-Related Advocacy

Overcoming Obstacles Webinar Series

Sustaining behavioral healthcare in your practice

This series of webinars was developed collaboratively by representatives of the 8 participating organizations. Most webinars include both primary care and psychiatric clinicians in a wide variety of settings, including small practices, and all provide practical, actionable strategies to help primary care practices sustain a collaborative and equitable approach to providing whole-person care to their patients. 

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  • Some webinars are available in podcast form on the AMA’s Moving Medicine channel (and available on Apple Podcasts). 

Why BHI

  •  – Physician experts provide insight on how and why primary care and mental health can work together (58 min) 
  •  – The speakers share examples of how all clinicians on the care team can break the stigma barrier and normalize mental health treatment. (61 min) 
  •  – This webinar relates how BHI has helped increase joy in practice and clinician satisfaction. (32 min) 
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  •  – This webinar focuses on how BHI can address disparities that affect racial, ethnic, and other populations. (60 min) 
  •  – Clinicians from small, independent practices share how they got started and how they overcame barriers. (62 min) 
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  • - Experts discuss the impacts on physicians and the care team, challenges encountered, and solutions used to creatively address patient needs since the pandemic. (44 min)

Implementation

  • - Explore skills and tools for physicians to deliver evidence-based interventions (e.g., motivational interviewing, shared decision making, and psychoeducation) within a single patient appointment. (47 min)"
  • - Experts explore available tools and resources to help primary care physicians determine best interventions to address behavioral health conditions. (31 min)
  • - This webinar explores how two physician practices use behavioral health specialists to expand access and treatment to patients with behavioral health conditions. One pediatrician discusses how her practice has improved mental health care for their low-income population and an internist discusses patients with substance use disorders. (30 min).
  •  – Physician experts share how they established workflows and “warm handoffs” for patients and the care team. (30 min) 
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  •  – This webinar explores the use of telehealth to support behavioral health of patients. (61 min) 
  •  – Experts review privacy, security, and what is permissible under current laws and regulations, including examples of how to safely integrate patient care while protecting patient privacy (63 min) 
  • – Experts share tips on how to identify practice needs, train care team members and assign roles and responsibilities for addressing patient behavioral health needs in a streamlined way. (49 min)

Special Populations

  • – Patients with chronic diseases are particularly prone to mental and behavioral health issues. This webinar highlights the role BHI plays in providing whole-person care. (59 min) 
  • – This webinar provides tips on how to implement suicide screening and prevention and what to do after a positive screen.(32 min)
  • – Building off the previous webinar, experts provide practical implementation strategies and one practice's lessons learned. (40 min)
  •  – Pediatric specialists share how they use BHI to provide whole-person care to children, adolescents, and their families (55 min) 

Billing and Financial Sustainability

  •  – This webinar explores how practices can plan for and sustain BHI in both FFS and value-based care arrangements. (67 min) 
  •  – This webinar provides an overview of billing for behavioral and mental health services across the spectrum from co-located to collaborative care, including CPT codes, services, and reporting requirements. (60 min) 
  •  – This webinar takes a deeper dive into billing and coding strategies specific to the Collaborative Care Model. (42 min) 
  •  – In this case study from Michigan, a major payer and a health system share their experience launching a successful BHI program. (39 min)