Public Health

How to assemble the best team to integrate mental health care

Tanya Albert Henry , Contributing News Writer

Building the right team is a foundational step to incorporating mental health care into your primary care practice. The right team can help with integrating behavioral health care to better treat your patients in a setting in which they are comfortable. The right team can also bring more long-term patient and professional satisfaction.

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During an AMA-hosted Behavioral Health Integration (BHI) Collaborative webinar, a physician and a licensed clinical social worker—who have successfully integrated behavioral health care into their practices—shared their experience and perspectives with listeners who want to bring together the right group of health professionals to successfully integrate and provide mental health care.

“Building your team is a critical and core step. You are putting together your team of superheroes who is going to do the necessary work for the patients in your practice,” Sarah Coles, MD, family physician and program director of the Colorado Plateau Family and Community Medicine Residency at North Country HealthCare—a teaching health center in Flagstaff, Arizona—said during the “Assembling the BHI Care Team: Roles and Responsibilities” webinar.

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It’s something you want to take the time to do right, Dr. Coles said. “If you put the right team in place, you can overcome any obstacles and barriers. It is well worth the extra thought and effort to find the right folks."

For example, she noted, the time to remission for patients with depression dropped to 86 days for those in their Collaborative Care Model practice setting—a fraction of the 614 days to remission for those in a traditional primary care setting. In addition to improved behavioral health outcomes, Dr. Coles said patients also potentially have improved physical health outcomes and safer medication management.



Dr. Coles said she was completely new to BHI when her practice determined it was best for patients and physicians, stressing that a practice can integrate mental health care even if it doesn’t have any experience with it.

To assemble the right team of people to be successful, Dr. Coles offered nine tips for physicians to follow:

  • Identify champions.
  • Recruit broadly because not everyone may be already in the practice.
  • Create stakeholder buy-in and actively engage all members of the team.
  • Use behavioral health-based interviewing for culture, fit and skills.
  • Seek diversity, inclusion and equity.
  • Focus on the mission.
  • Use creative problem-solving to overcome barriers and reinforce and reward successes.
  • Train and train again.
  • Allow for psychological safety.

Check out the BHI Collaborative’s Behavioral Health Integration Compendium, which provides health care organizations with a proven pathway for delivering integrated behavioral health care and ensuring they have the most recent, actionable information at their disposal.

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Hiring the right care manager is a big part of the key to success—the glue that holds the team together—said Jennifer Schwartz, a licensed master social worker and the behavioral health program manager and therapist for Corner Health Center in Ypsilanti, Michigan.

“One person who will determine the flexibility and adaptability of your team is that behavioral health care manager,” Schwartz said. “They are the star of the coordination team. This person is responsible for so many different things that must happen in order for this model to be really, really effective and give you the efficiency you are seeking.”

In an integrated care model, the care manager is responsible for maintaining a strong connection between the patient and the practice. They are also responsible for advocating and communicating to the physician on the patient’s behalf, ensuring accurate documentation of the patient’s progress to guide the consultant’s focus, recording client services and communicating with the medical professional to drive billing.

Consequently, it’s important to take the time to find the right person for the role, even if it means recruiting people from outside the practice to hire the person with the right skill set and personality.

The AMA established the BHI Collaborative with seven other leading physician organizations to catalyze effective and sustainable integration of behavioral and mental health care into physician practices. Learn more with the collaborative’s “Overcoming Obstacles” webinar series.