Education and Workforce

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 disorder1; 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 year2. 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 States3. However, multiple studies suggest that collaboration between medical and behavioral health providers improves patient outcomes and satisfaction4,5.

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 services6.

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.

[1] Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272(22):1749-1756.

[2] Wang PS, Lane M, Olfson M, et al. Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. JAMA Psychiatry 2005;62(6):629-640.

[3] Goodheart C. Economics and psychology practice: what we need to know and why. Prof Psychol-Res Pr 2010;41(3):189.

[4] Oishi SM, Shoai R, Katon W, et al. Impacting late life depression: Integrating a depression intervention into primary care. Psychiatr Q 2003;74(1):75-89.

[5] Oxman TE, Dietrich AJ, Schulberg HC. The depression care manager and mental health specialist as collaborators within primary care. Am J Geriatr Psychiatry 2003;11(5):507-516.

[6] Blount FA, Miller BF. Addressing the workforce crisis in integrated primary care. J Clin Psychol Med Settings 2009;16(1):113-119.


Latest News

APA Recommends Integrated Care Training for Psychiatrists

The American Psychiatric Association (APA) released in March 2015 new training recommendations calling for residency programs to educate the next generation of psychiatrists in integrated behavioral health care. These training recommendations inform all spans of a practicing or prospective psychiatrist’s education, including undergraduate and graduate medical education as well as continuing medical education.

Supervision in Primary Care – CFHA Blog Posts

Recent Collaborative Family Healthcare Association (CFHA) blog posts have featured approaches to supervision of behavioral health professionals in primary care.

Staffing for Depression Care in Primary Care Clinics

The Depression Improvement Across Minnesota, Offering A New Direction (DIAMOND) collaborative care initiative, supported by the Institute for Clinical Systems Improvement, provided similar training and support for 87 primary care clinics but varied staffing and care manager positions. Care managers were registered nurses, certified medical assistants, or licensed practice nurses.

Four Pillars for Primary Care Physician Workforce

Despite the changing health care environment’s increasing need for primary care physicians that can manage populations, deliver care in interdisciplinary teams and address quality outcomes, national data indicate that not enough students and residents are choosing careers in primary care. According to family medicine organizations and researchers, “factors that influence specialty choice [include] individual learner characteristics, training and practice environments, and payment systems.

Proximity of Behavioral Health and Primary Care Providers

Despite increasing awareness of integrated behavioral health and primary care, little is known about the distribution of integration across the United States. Currently, there is a lack of information at the state and national levels about:

Workforce Competency Skills Improved by UMass Certificate Program

Demonstrated workforce competencies are essential to successfully meet both patient and provider needs and cost constraints in integrated primary care settings. Since 2007, approximately 1,500 health care professionals have received this specialized training through The Certificate Program in Primary Care Behavioral Health at the University of Massachusetts’ Center for Integrated Primary Care.

Expert Insight

Social Work Students and Integrated Primary Care

Sandra Bailly, M.S.W, of the Simmons School of Social Work, interviewed Alexander Blount, Ed. D., Director of the Center for Integrated Primary Care at the University of Massachusetts Medical School. This interview outlines what social work students should expect when learning about the practice of integrated primary care, as well as the training implications for those in that field. Dr. Blount says that social workers and primary care providers (PCPs) face many of the same challenges because the majority of behavioral health issues will only ever be treated in the primary care setting.

Mon, 11/03/2014

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.