What’s the news: One of the more effective solutions to increasing access to treatment for many mental health conditions has been the integration of behavioral and physical health care. However, sustained behavioral health integration (BHI) has only occurred in a small subset of practices.
The AMA partnered with the RAND Corporation to determine specific factors that influence the implementation of BHI to help inform solutions for this persistent disparity in mental health care. Together with the RAND Corporation, the AMA looked at the motivators, facilitators and barriers to behavioral health integration from the perspectives of 30 physician practices with firsthand experience.
Published in the journal Annals of Internal Medicine, “Factors Influencing Physician Practices’ Adoption of Behavioral Health Integration in the United States: a Qualitative Study,” found that the motivations for behavioral health integration are broad, including expanding access to behavioral health services, improving other health professionals’ abilities to respond to patients’ behavioral health needs and enhancing practice reputation.
Additionally, the study found that physician practices:
- Tailor implementation of models to fit their individual contexts including local resources, financial incentives and patient populations.
- Face multiple barriers to successful integration including billing difficulties as well as cultural differences and incomplete information flow between behavioral and nonbehavioral health professionals.
- Use a variety of approaches to financially support integration, not all of which are sustainable.
These findings will be used to help identify and spread effective solutions for sustainable behavioral health integration, particularly as the COVID-19 pandemic continues.
Why it’s important: One in five adults suffers from a mental health condition or substance use disorder. However, stigma and behavioral health workforce shortages lead to a mismatch in prevalence of these conditions and the proportion of people who receive effective treatment. With so many Americans affected by a mental health condition, these individuals are still not receiving the care they need. The COVID-19 pandemic only exacerbates these problems.
“The COVID-19 pandemic has exposed and magnified the flaws in our mental health system and the true burden of mental illness in our country,” said AMA President Patrice A. Harris, MD, MA. “Behavioral health care integration can help save lives and is a proven model that has many advantages over a more divided one.”
Additionally, practices that are currently providing behavioral health services continue to face cultural and financial barriers to implementing and sustaining this integration. Practices need tailored, context-specific technical support to guide their implementation and payment models. Such improvements to the business case for practices can help enhance the dissemination and long-term sustainability of behavioral health integration.
Learn more: Physicians can learn more about the benefits and challenges of implementing behavioral health services by listening to the featured episode on the Perspectives with AMA podcast series, “Behavioral Health Integration: Exploring Its Effect on Clinical Practice.”
The AMA has put together evidence-based tools, resources and information to improve behavioral health during the COVID-19 pandemic and beyond. The AMA is also seeking and creating opportunities to accelerate the adoption of behavioral health integration in practice and increase its long-term sustainability.
Additionally, AMA’s STEPS Forward™ open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. In particular, the CME module, “Behavioral Health: Expand Patient Care and Improve Practice Efficiency,” which is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit, provides five steps to integrate behavioral health into primary care.
The module is part of the AMA Ed Hub, an online platform with top-quality CME and education that supports the professional development needs of physicians and other health professionals. With topics relevant to you, it also offers an easy, streamlined way to find, take, track and report educational activities. Learn more about AMA CME accreditation.
Resources are also available from the AMA to help physicians manage their own mental health and well-being during the COVID-19 pandemic. The AMA also provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.
Learn more about what should be included in a national prevention strategy on long-term health and well-being for physicians on the front lines of COVID-19.
Essential Tools & Resources
Practice Transformation Resources
STOP This, START That Checklist
Creating a Strong Team Culture
Debunking Regulatory Myths