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 2016 Uniform Data System (UDS) data, health centers achieved the following:

  • Over 8.5 million mental health visits
  • More than 9,190 behavioral health FTEs to include psychiatrists, psychologists, social workers and substance use disorder specialists:
    • Psychiatrists: 687.78 FTEs
    • Licensed Clinical Psychologists: 821.73 FTEs
    • Licensed Clinical Social Workers: 3,171.58 FTEs
    • Other Licensed Mental Health Providers: 2,298.46 FTEs
    • Other Mental Health Staff: 2,212.27 FTEs
  • Mental health patients increased by 19.88% from 2015 (1,491,926) to 2016 (1,788,577)
  • Depression screenings and follow-up measure for patients increased by nearly 10% from 2015 (50.61%) to 2016 (60.34%)
  • Nearly 90% 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.

  • Substance Use Warmline
    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.
  • Opioid Addiction Treatment ECHO
    This ECHO provides health center staff with free training and support in treating opioid use disorder via videoconferencing technology.
  • SAMHSA-HRSA Center for Integrated Health Solutions (CIHS)
    CIHS is a national training and technical assistance center focused on the integration of primary and behavioral health care and related workforce development.
  • 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
    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.