Education and Workforce

There is a significant need to train behavioral health and primary care clinicians to work together as teams.

An estimated 26 percent of patients seen in primary care meet criteria for a mental disorder (Spitzer et al., 1994); however, according to a large national sample survey (n = 9,282), only 41 percent of people with mental disorders received any form of treatment in the preceding year (Wang, et al., 2005). And while more of these people received treatment in primary care than in any other setting, the treatment provided in the primary care setting met minimal adequacy standards only 13 percent of the time.

Neither the professional workforce nor the system of structuring and paying for care is adequate to address the need for behavioral health services in the United States (Goodheart, 2010). However, multiple studies suggest that collaboration between medical and behavioral health providers improves patient outcomes and satisfaction (Oishi, Shoai, Katon, et al, 2003; Oxman, Dietrich, and Schulberg, 2003).

Education and training of the workforce is essential if we hope to adopt integrated behavioral health and primary care on a widespread basis.

Integrated care team members may include:

Primary care clinicians, physician’s assistants, psychiatrists, nurse practitioners
Behavioral health providers such as social workers, psychologists, mental health counselors, substance abuse counselors, and family and marriage therapists
Allied health professionals or paraprofessionals such as health educators, care coordinators, depression care coordinators, community health workers, promotores de salud, peer coaches, or patient navigators.

Since our traditional educational and training paradigm has not focused on collaboration and a comprehensive, team-based approach, the majority of our health care workforce has not received training on working together to provide effective integrated services.

Training and education programs that are focused on integration are emerging. More than 90 are listed in our Programs section.

Visit the literature collection for a list of citations on integration Education and Workforce issues.

Training for Behavioral Health Integration into Primary Care

In response to the demand for behavioral health providers in primary care, initiatives have developed which attempt to provide training for the established behavioral health workforce to enable their successful integration into primary care settings. The need to address this workforce shortage continues to grow as behavioral health services in primary care become more widely implemented. In this article Dr. Alexander Blount of the NIAC, expresses the importance of training for behavioral health providers in primary care.

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