Purpose
Recognizing the growing movement toward whole-person care, the AHRQ Academy developed this Integrated Behavioral Health Playbook as a guide to help primary care providers and practices integrate behavioral health into the care they provide their patients. Integrated behavioral health aims to help improve access to behavioral health care and improve health care delivery. Integrating behavioral health and primary care can achieve better patient health outcomes by improving a practice's ability to effectively:
- Address the interconnectedness of behavioral health, medical conditions, and emotional and social well-being,
- Prevent fragmentation between behavioral health and medical care, and
- Build collaborative relationships with mental health and substance use services, and other community agencies and support outside the primary care setting to support the delivery of whole-person care.
Ultimately, the goal of integrated behavioral health care is better care and better health.
This Playbook aims to address the growing need for practical guidance and resources as more primary care practices and health systems begin to design and implement integrated behavioral health services that address mental health and substance use treatment needs, as well as the behavioral aspects of medical conditions. Although many practices want to offer integrated behavioral health care, making the transition takes planning and resources, which can seem daunting. The Playbook's framework is designed to be useful for practices implementing any model or degree of integration, and support their transition to delivering care that goes beyond treating a person's symptoms, individual organs, or body systems and addresses the whole person. While other existing frameworks excel at describing and measuring the integration of behavioral health and primary care, this Playbook stands apart by providing the "nuts-and-bolts" practical guidance on how to implement it. The processes and steps outlined in this Playbook establish the foundational infrastructure and workflows necessary to address mental health, substance use, behavioral change, and health-related social needs via screening and assessment, risk stratification, tailored interventions supported by measurement and evaluation, and community partnerships. This infrastructure supports the shift to whole-person care and population health management, two strategies for improving health outcomes.
This Integration Playbook is accompanied by a video, which 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, but can be applied to your unique practice context, no matter how large or small your practice, or in other ambulatory care settings. Tips and examples are offered with primary care in mind, but can easily translate to medical specialties such as obstetrics, neurology, oncology, or occupational medicine.
The Playbook gives particular guidance on how primary care practices that serve under-resourced communities, whether due to geography or demography, and experience barriers to access for both physical and behavioral health care, can successfully integrate treatment for mental health and substance use disorders into the care they offer their patients.
Revised By (5/5/2025)
Monique Thornton, M.P.H.7; Neil Korsen, M.D., M.Sc.2; Anna Cupito3; Danielle Durant, Ph.D., M.S., M.S., M.B.A.3; Alec Hester, P.M.P.3; Garrett Moran, Ph.D.4
Originally Prepared By
Neil Korsen, M.D., M.Sc.2;Alexander Blount Ed.D.5; C. J. Peek, Ph.D.6; Roger Kathol M.D., C.P.E.7; Vasudha Narayanan, M.A., M.B.A., M.S.3; Natalie Teixeira, M.P.H.3; Nina Freed, M.P.H.3; Garrett Moran, Ph.D.3; Allison Newsom, B.S.3; Joshua Noda, M.P.P.3;Benjamin F. Miller, Psy.D.8
Acknowledgments
We thank Elisabeth Kato, M.D. and Matthew Simpson, M.D., M.P.H., Agency for Healthcare Research and Quality, for their 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:
Affiliations
1Let's Talk Public Health, LLC, Washington, DC
2MaineHealth, Portland, ME
3Westat, Rockville, MD
4 Moran Consulting
5University of Massachusetts Medical School, Worcester, MA
6Universityof Minnesota Medical School, Minneapolis, MN
7Cartesian Solutions, Inc., Burnsville, MN
8University of Colorado Denver School of Medicine, Denver, CO