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Eight health groups say it’s time to integrate behavioral health and primary care


The organizations make a case for combining physical and behavioral health, but they say policymakers and insurers must step up to make it a reality.

Healthcare advocacy groups are coming together to push for the greater integration of behavioral health into primary care.

Eight prominent national organizations have formed the BHI Collaborative to draw attention to the growing need to merge physical health and behavioral health.

In a July 8 article in Health Affairs, the groups wrote, “Existing systems are failing to meet the need for whole-person care, including addressing the impact of life stressors and trauma, which have only intensified during the COVID-19 pandemic.”

The groups called on federal and state policymakers and insurers to help make this happen.

“More people than ever are struggling with their behavioral health, including both mental health and substance use disorders,” the article states. “We believe, therefore, that our primary care systems must urgently embrace a paradigm shift, accelerating the adoption of behavioral health integration (BHI) in physician practices and addressing this rampant increase in unmet needs.”

The members of the BHI Collaborative are: the American Academy of Child and Adolescent Psychiatry, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Medical Association, the American Osteopathic Association, and the American Psychiatric Association. The collaborative was established in 2020.

The health groups call for incorporating behavioral health screenings to help patients get treatment sooner.

In addition to offering better care, the health organizations say improved integration will reduce the stigma that some still associate with seeking behavioral health treatment.

The groups pointed to some critical steps needed to incorporate behavioral health more effectively into primary care.

They called for sustainable funding for training and education. They also stressed the need for more federal aid to build a more robust behavioral health workforce, including psychiatrists and behavioral-developmental pediatricians, particularly in underserved areas.

The health groups also called for increased payment levels for behavioral health integration in federal and state programs. And they said policymakers should work with health plans and coverage programs to limit use management review practices and enforce laws on behavioral health parity.

To make behavioral health a bigger part of primary care, doctors need help from policymakers and payers, said Gerald Harmon, former president of the American Medical Association and a co-author of the Health Affairs article.

“Even with a clear recognition that our primary care systems must urgently embrace a paradigm shift to stem the growing behavioral health crisis, there remain significant challenges in building clinical pathways that provide whole person care,” Harmon said in a statement. “These challenges cannot be overcome by physicians alone, and we are calling on payers and policymakers, among other industry stakeholders, to rally around a set of key solutions in partnership with physicians.”

Sterling N. Ransone Jr., president of the American Academy of Family Physicians and another co-author, said the collaborative is committed to merging behavioral health into primary care practices.

“The COVID-19 pandemic has exacerbated an already-present mental health crisis in our country, and our patients deserve primary care that sees the whole person,” Ransone said in a statement. “Enhanced mental health screening and coordination of physical and behavioral health care services will serve our patients best.”

Mark Del Monte, chief executive officer of the American Academy of Pediatrics, said it’s time to meet critical needs of behavioral and mental health. As many as 50% of behavioral health disorders begin by age 14, the article states.

“Pediatricians have observed and raised alarm about the mental health crisis confronting children and adolescents well before the pandemic, and we are now facing a pivotal moment where urgent action is needed in and outside of pediatric offices to help confront it,” Del Monte said in a statement.

Depression and substance use disorder are among the top 10 causes of death among American adults, the article noted.

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