The tools and strategies available for use in the implementation of integration are increasing. An insight into some of those is provided in Integration of Mental Health/Substance Abuse and Primary Care, and  the IBHC Measures Atlas.

Clinical Outcome Measures

A literature search was conducted to find peer reviewed articles and reports that focus on the quality of integration between behavioral and physical health care settings.  The literature search was limited to prevalent physical and mental health conditions that are commonly comorbid such as diabetes, cardiovascular disease, depression, and anxiety.  Clinical health outcomes were used as the primary markers of quality.

In conducting the literature search, researchers first performed an extensive search for clinical outcome measures that assess the quality of integration in health care settings utilizing the following resources:  the National Quality Measures Clearinghouse, Applied Social Sciences Index and Abstracts (ASSIA), Health and Psychosocial Instruments (HAPI), PsycINFO, and PUBMED.  In addition to a general search to update the 2012 work, searches were also conducted specifically focusing on financial outcomes and provider experience with integrated behavioral health care.  An initial review of articles from the searches suggested that no specific clinical outcome measures for evaluating quality of integrated care exist.  Measures in the articles either focused on an individual behavioral health condition or the physical health outcome alone. A final search was then conducted to identify additional articles on the psychometric properties of the outcome measures based on survey instruments. 

The measures from the literature search were evaluated based on sensitivity, specificity, validity, and reliability. In order to be selected for the final list of clinical outcome measures, the measure was required to have at least 2 good psychometric properties. Below is the final list of clinical outcome measures from the literature search:


Generalized Anxiety Disorder scale (GAD-2)

Generalized Anxiety Disorder scale (GAD-7)


Center of Epidemiological Studies-Depression (CES-D)

Geriatric Depression Scale-15

Geriatric Depression Scale-30

Hamilton Depression Rating Scale

Patient Health Questionnaire-2

Patient Health Questionnaire-9

Zung Self Rating Depression Scale


Optimal Diabetes Care

Optimal Vascular Care

Physical Health Conditions

Arthritis Impact Measurement Scales (AIMS)

Health Assessment Questionnaire-Disability Index (MHAQ-DI)

Multidimensional Health Assessment Questionnaire (MDHAQ)
Copyright: Health Report Services, 615-479-5303,

RAND 36-Item Short Form Health Survey

World Health Organization Quality of Life Brief Instrument


Substance Use/Substance Abuse

Drug Abuse Screening Test (DAST)
© Copyright 1982 by Harvey A. Skinner, PhD and the Centre for Addiction and Mental Health, Toronto, Canada. You may reproduce this instrument for non-commercial use (clinical, research, training purposes) as long as you credit the author Dr. Harvey A. Skinner, York University, Toronto, Canada.

Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)
Reproduced with permission of the World Health Organization

Alcohol Use Disorders Identification Test

Reproduced with permission of the publisher from Babor, TF, Higgins-Biddle, JC, et al. The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, 2nd ed. Geneva, World Health Organization, 2013

Alcohol Use Disorders Identification Test Consumption (AUDIT-C)