Researchers are exploring methods to integrate behavioral health into primary care, as noted in a Rutgers Health study published in the Journal of the American Board of Family Medicine. This study identifies six strategies to successfully incorporate behavioral health services into primary care settings to enhance patient outcomes.
Ann Nguyen, an assistant research professor at the Center for State Health Policy within the Rutgers Institute for Health, Health Care Policy and Aging Research, emphasized the significance of this integration, stating, “More than 70% of primary care visits have some behavioral health component.” She highlighted the challenge of addressing these components during the brief 15 to 20-minute typical primary care appointments.
The study focused on ten New Jersey health centers that implemented the “Cherokee Model” of integrated care from 2013 to 2019. This model includes an immediate “warm handoff” to a behavioral health clinician after a patient sees their primary care doctor, allowing for seamless care within the same visit. Nguyen mentioned the importance of this approach: “We really want to see behavioral and physical health happening all under the same roof as part of the same visit.”
The researchers identified six key strategies for successful implementation: employing experienced change champions for staff buy-in, specialized training on brief interventions, ongoing training for new staff, dedicated spaces near exam rooms, effective scheduling systems, and guidance on local billing codes.
Although this model has proven effective, barriers to broader adoption persist. Nguyen pointed out, “Behavioral health services often aren’t reimbursed at high enough rates to cover costs.” Additionally, dividing behavioral from physical health and space limitations pose challenges.
Despite these issues, integrated behavioral health has shown clinical improvements for conditions such as depression, anxiety, and substance use disorders, decreasing system costs and increasing patient and provider satisfaction. Nguyen also noted its preventative nature, stating, “We’re catching things and changing behaviors early on, so patients don’t later on need expensive specialized services or end up in the ER.”
The research team is now expanding their study nationally to assess systems that have successfully integrated behavioral health. They aim to work with health systems to develop automated reports that illustrate the financial and clinical impacts of integrated care.
Nguyen concluded, “Behavioral health is a huge challenge, not just in terms of devising effective and economical ways that providers can offer it but also in terms of actually changing patient behavior. Still, it’s vital that we find strategies that work because how patients behave day-to-day has a greater impact on wellbeing than anything we can do for them after they get sick.”
