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AHRQ: Agency for Healthcare Research and Quality

Integrating Behavioral Health and Primary Care Playbook

Purpose

The AHRQ Academy developed the Playbook as a guide to integrating behavioral health in primary care and other ambulatory care settings to help improve health care delivery to achieve better patient health outcomes. Integrated primary care can improve a practice’s ability to effectively:

  • Address behavioral health and medical conditions,
  • Prevent fragmentation between behavioral health and medical care, and
  • Build relationships with mental health specialists outside the primary care setting.

The goal of integrated primary care is better care and better health. The basics of integrating behavioral health in primary care are the same elements an organization needs to provide good care in general.

The Playbook aims to address the growing need for guidance as more primary care practices and health systems begin to design and implement integrated behavioral health services. The Playbook’s framework is designed to be useful for practices implementing any level of integration.

The Integration Playbook video provides an overview of the Playbook's content areas and features.

Intended Audience and Users

The Playbook is intended for practices working to integrate behavioral health in primary care settings, and can be applied in other ambulatory care settings. The information provided in the Playbook can be applied to your unique practice context, no matter how large or small your practice. Tips and examples are offered with primary care in mind, but can easily translate to medical specialties such as neurology, oncology, or occupational medicine.

Although the Playbook focuses on ambulatory settings, similar approaches to integration are also vital for inpatient settings. Eventually, the Playbook may be expanded to be of use to other audiences, including health plans, accountable care organizations, and policymakers.

Prepared By

Neil Korsen, M.D., M.Sc.1; Alexander Blount Ed.D.2; C. J. Peek, Ph.D.3; Roger Kathol M.D., C.P.E.4; Vasudha Narayanan, M.A., M.B.A., M.S.5; Natalie Teixeira, M.P.H. 5; Nina Freed, M.P.H. 5; Garrett Moran, Ph.D. 5; Allison Newsom, B.S.5; Joshua Noda, M.P.P. 5; Benjamin F. Miller, Psy.D.6

Acknowledgments

We thank Charlotte Mullican M.P.H., Agency for Healthcare Research and Quality, for her support, insightful comments, and guidance.

We thank members of the National Integration Academy Council (NIAC) for sharing their time and expertise to improve this work: Macaran Baird7, Teresa Chapa8, David deBronkart9, Frank Verloin deGruy6, Michael Hogan10, Parinda Khatri11, Stephen Melek12, Kavita Patel13, Jürgen Unützer14, and Steven Waldren15.

We thank the Westat Graphics Department and Informatics Studio Inc. for Playbook Web design and development. We additionally thank Kathryn McKay and Mary Grady at the Agency for Healthcare Research and Quality and Calvin Pierce5 for their contributions.

Affiliations

1MaineHealth, Portland, ME 

2University of Massachusetts Medical School, Worcester, MA

3University of Minnesota Medical School, Minneapolis, MN

4Cartesian Solutions, Inc., Burnsville, MN

5Westat, Rockville, MD

6University of Colorado Denver School of Medicine, Denver, CO

7University of Minnesota Department of Family Medicine and Community Health, Minneapolis, MN

8US Department of Health and Human Services, Office of Minority Health, Rockville, MD

9ePatientDave.com, Nashua, NH

10Hogan Health Solutions LLC, Delmar, NY

11Cherokee Health Systems, Knoxville, TN

12Milliman, Denver, CO

13Engelberg Center for Health Care Reform at the Brookings Institution, Washington, DC

14University of Washington Department of Psychiatry and Behavioral Sciences, Seattle, WA

15American Academy of Family Physicians, Leawood, KS