Behavioral Health and Primary Care Integration

Primary care settings have become a gateway for many individuals with behavioral health and primary care needs. To address these needs, primary care providers integrate behavioral health care services into their practice settings.

Health centers provide both mental health and substance use services.

  • Screening for mental health and substance use disorders
  • Developmental screenings
  • Counseling and psychiatry
  • 24-hour crisis intervention
  • Medication assisted treatment for substance use disorders; detoxification, recovery support

Health Center Behavioral Health Performance Measure Accomplishments

According to 2018 Uniform Data System (UDS) data, health centers achieved the following:

  • Over 10.8 million mental health visits
  • More than 11,700 behavioral health FTEs to include psychiatrists, psychologists, social workers and substance use disorder specialists:
    • Psychiatrists: 814.4 FTEs
    • Licensed Clinical Psychologists: 924.9 FTEs
    • Licensed Clinical Social Workers: 4,132.3 FTEs
    • Other Licensed Mental Health Providers: 3,382.1 FTEs
    • Other Mental Health Staff: 2,516.1 FTEs
  • Mental health patients increased by 9.8% from 2017 (2,049,194) to 2018 (2,249,876)
  • Depression screenings and follow-up measure for patients increased by nearly 5% from 2017 (66.2%) to 2018 (70.6%)
  • Approximately  95% of HRSA health centers provide mental health services
  • Additional health center data and reporting information

HRSA Behavioral Health Initiatives

Resources

Primary care settings facilitate access to behavioral care for many individuals presenting with behavioral health needs. Health centers looking to integrate behavioral health into the primary care setting may benefit from the following resources that highlight key considerations around integration.

UDS Resources

Each year, health center grantees and look-alikes report on their performance using the measures defined in the UDS. Resources to assist health centers in collecting and submitting their data include UDS manuals, webinars, trainings, validations, crosswalks, and other technical assistance resources.

UDS Table 6B - Quality of Care Measures: Depression Screening and Follow-up

This clinical quality measure requires health centers to report the number of patients age 12 and older screened for depression and, if diagnosed, receiving a follow-up plan.

UDS Table 6A - Selected Diagnoses and Services Rendered: Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Health centers annually report this performance measure, as well as other substance use counseling and treatment services.

  • HRSA Webinar: NIDAMED: Provider Resources on Substance Use Exit Disclaimer
    Watch an overview of the National Institute on Drug Abuse’s (NIDA) online repository of science-based resources for health professionals on substance use disorder called NIDAMED. Experts discuss NIDAMED’s resources, including continuing medical education courses, patient resources, and clinical trial information. The discussion also focuses on available substance use disorder screening guidance and tools.
  • HRSA’s Opioid Crisis Website
  • This website provides HRSA-supported resources, technical assistance, and training to integrate behavioral health services into practice settings and communities in response to the opioid crisis.
  • Primary Health Care Digest Special Edition on Opioids 
    HRSA’s special edition newsletter provides resources and best practices to help health centers meet the challenges of providing substance use disorder services, including addressing opioid use disorder.
  • Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (NSDUH)
    SAMHSA’s NSDUH annual report presents the 2018 national estimates of use of alcohol, tobacco products, illicit drugs, substance use disorders, and substance use treatment among people 12 years of age and older.
  • Professional Education Materials on Alcohol
    The National Institute on Alcohol Abuse and Alcoholism provides resources for clinicians and other health care professionals on underage and college drinking, alcohol screening and brief intervention, medications for the treatment of alcohol use disorder, and more.
  • Alcohol Use Disorder Brochures and Fact Sheets
    The National Institute on Alcohol Abuse and Alcoholism offers easy-to-read information for patients on a wide range of alcohol-related topics.
  • CDC’s Alcohol Portal
    CDC’s Alcohol Portal compiles information on the health effects of drinking alcohol. It includes patient fact sheets, as well as information for providers on alcohol screening and brief intervention and evidence-based strategies to prevent excessive alcohol use.
  • Alcohol Screening and Brief Intervention for People Who Consume Alcohol and Use Opioids
    This CDC webpage provides information on how health care providers can use alcohol screening and brief intervention (ASBI) before prescribing opioids to reduce opioid overdose deaths involving alcohol.
  • Substance Use Warmline HRSA BPHC exit disclaimer
    This Warmline provides free clinician-to-clinician consultation over the phone, assisting primary care clinicians in addressing the difficult issues of substance use disorder, chronic pain, and behavioral health.
  • Integrated Health Solutions HRSA BPHC exit disclaimer
    The website for SAMHSA’s new Center of Excellence for Integrated Health Solution provides information on promising practices in integrated behavioral health care, financing, and workforce training and tools.
  • SAMHSA's Knowledge Network
    SAMHSA’s library hosts a wealth of resources on behavioral health training, technical assistance, collaboration, and workforce development for the health care community.
  • Addiction Technology Transfer Center (ATTC) Network Exit Disclaimer
    SAMHSA’s Addiction Technology Transfer Center (ATTC) Network trains providers using the latest evidence-based practices, current research, and creates alliances among agencies and organizations that provide substance use disorder treatment and recovery services.

 

Date Last Reviewed:  December 2019