Integrating Behavioral Health & Primary Care

The Patient-Centered Primary Care Collaborative reports that 30%-50% of referrals from primary care providers to behavioral health specialists never make it, if their physician can get them an appointment at all. However, only 50% of behavioral disorders are treated in a primary care setting, even though researchers have found that a large proportion of those with a behavioral disorder visit a primary care facility at least once a year.


Integrating behavioral health and primary care is a cost-effective way of increasing access to behavioral health services, treatment adherence, and follow-up; addressing mental and physical co-morbidities, recognizing that mental illness and substance abuse can be at the root of physical ailments and vice-versa; and helping to reduce stigma associated with seeking behavioral health care.

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), in 2011, “20 million people who needed substance abuse treatment did not receive it and an estimated 10.6 million adults reported an unmet need for mental health care” – many of whom rely heavily on safety net clinics and programs.

For more information on integrating behavioral health and primary care, check out the resources below and in the purple tab to the right side of this page.


In addition to primary care services, patients of Montgomery Cares have access to behavioral health services through the Montgomery Cares Behavioral Health Program (MCBHP), founded in 2001 in response to behavioral health needs observed among Montgomery Cares patients. MCBHP is also administered by the Primary Care Coalition of Montgomery County, MD. Through the MCBHP, bilingual care managers, family support workers, and a part-time consulting psychiatrist form part of the primary care settings’ care team and connect patients with behavioral health problems, including depression, substance abuse, severe mental illness, and domestic violence, among others, with the appropriate services.

bpc integrating mental health

Integrating Clinical and Mental Health: Challenges and Opportunities

The Bipartisan Policy Center report, Integrating Clinical and Mental Health: Challenges and Opportunities, examines the barriers to the integration of clinical health care and mental health services, and identifies policy options for consideration in advancing integration. While progress has been made with the development and evaluation of integrated care models in improving quality of care, the elimination of organizational and financial disincentives remain challenges. Upon the report’s release, a panel of national leaders in integrating care examined the existing delivery structure, public and private program financing, practitioner challenges, accomplishments on the ground, and consumer priorities.

What Does it Take to Become Trauma-Informed? Lessons from Early Adopters

Trauma-informed care is crucial to improving how health care organizations deliver services to people who have experienced adverse life events. Through the Advancing Trauma-Informed Care (ATC) initiative, and with support from the Robert Wood Johnson Foundation, the Center for Health Care Strategies convened innovators in the field to build on existing trauma-informed efforts and share lessons learned. The Urban Institute conducted an implementation analysis to better understand how participating pilot sites adapted clinical and organizational practices to advance trauma-informed care. Key findings from the study, Early Adopters of Trauma-Informed Care: An Implementation Analysis of the Advancing Trauma-Informed Care Grantees, show that successful trauma-informed organizations held these elements in common:

  • Prioritize organizational culture change
  • Incorporate patient voice to guide the process of becoming trauma-informed
  • Train all staff and review hiring practices to promote a trauma-informed workforce
  • Encourage self-care to prevent burnout
  • Screen patients for trauma and its symptoms
  • Deliver trauma-specific services to patients
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