Incorporating mental health services with medical care improves care quality and expands access to behavioral health services, but optimal integration remains limited by cultural and financial barriers. Leading physician organizations have come together to change that.

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The Behavioral Health Integration (BHI) Collaborative is a response by the AMA and other physician organizations to expand the limited access patients have to mental health care particularly during this time of acute psychological distress. The BHI Collaborative will provide support to physicians and help them combine mental and physical health in their medical practices.

“Without a clear road map for success, integrating mental and physical health services has been a challenge for medical practices," said AMA Immediate Past President Patrice A. Harris, MD, MA. "The AMA is committed to accessible and equitable treatment for behavioral, mental and physical health needs, and the BHI Collaborative will provide physicians with a proven playbook for implementing a holistic approach to physical, mental and behavioral health to meet the needs of all patients.”

Established and supported by the AMA, the BHI Collaborative brings together the collective expertise of the American Academy of Child & Adolescent Psychiatry, American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association and American Psychiatric Association.

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The need is clear

One in five adults, and one in six youth, in the U.S. experience mental illness, yet many do not receive treatment due in part to a shortage of mental health providers and lack of access to mental health services.

Additionally, the psychological toll of the COVID-19 pandemic continues to grow as Americans confront stress, isolation, and traumatization. More than half of Americans feel their mental health has deteriorated during the pandemic, according to a Kaiser Family Foundation survey.

The negative mental health impact of COVID-19 has been disproportionately experienced among Black and Latinx patients, says a Centers for Disease Control and Prevention study that found growing anxiety, depression, substance use and suicide ideation.

A promising solution is integrating behavioral health into medical care, but optimal integration remains limited by cultural and financial barriers, among other factors, according to a recent RAND Corp. study conducted in collaboration with the AMA.

The RAND and AMA researchers noted, however, that these barriers might be overcome with the right approach.

“Tailored, context-specific technical support to guide practices' implementation and payment models that improve the business case for practices may enhance the dissemination and long-term sustainability of behavioral health integration,” the researchers wrote in their study: “Factors Influencing Physician Practices’ Adoption of Behavioral Health Integration in the United States,” which was published in Annals of Internal Medicine.

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This is exactly what the BHI Collaborative is intended to do. It will house an online collection of physician-tested resources that lay out a proven pathway for delivering behavioral and mental health care in a primary care setting.

As the compendium grows, it will include free access to online webinar programming, remote learning opportunities and other resources with key steps, best practices, and tools to accelerate behavioral health integration. These will include suggestions for fostering collaborative cultures and strong patient engagement, supporting accurate billing and coding, and incorporating telehealth into a practice.

“Integrating mental and physical health services has been a challenge for medical practices without a clear and efficient course to success," said AMA Immediate Past President Patrice A. Harris, MD, MA, a child psychiatrist in Atlanta.

"The AMA is committed to equitable and accessible treatment for behavioral, mental and physical health needs, and the BHI Collaborative will provide physicians with a proven playbook for implementing a holistic approach to physical, mental and behavioral health to meet the needs of all patients,” Dr. Harris added.

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