As the importance of behavioral health integration continues to gain momentum, a significant challenge has emerged. Many primary care clinicians express a strong desire to provide more behavioral health services, but they are hindered by a lack of training, tools, and resources. A recent report from The Advisory Board, based on a survey of 300 primary care providers (PCPs), sheds light on this issue, revealing that although nearly 40% of PCPs are screening their patients for behavioral health conditions, the majority still lack the necessary support to effectively incorporate these screenings into their practice.
The integration of primary and behavioral health care has been an ongoing conversation as more providers and payers recognize the benefits of offering comprehensive care. The report underscores the challenges PCPs face in addressing behavioral health concerns, with the bulk of clinicians attributing the increased screening to more patients presenting with behavioral health issues. However, only 20% of those surveyed reported being incentivized or reimbursed for conducting these screenings. The Advisory Board’s findings reveal that when providers are financially supported or incentivized for performing behavioral health integration tasks such as screenings, they are more likely to make these screenings a regular part of their clinical practice.
Primary care settings are often the first stop for patients seeking help with behavioral health concerns. According to the Advisory Board report, approximately 90% of patients with low-acuity behavioral health issues are likely to seek care from their PCP. This makes primary care providers a critical component of the early detection and treatment of behavioral health issues, as patients often turn to their trusted PCPs for help when they are struggling with issues such as anxiety, depression, or other behavioral health disorders.
Despite the important role primary care providers play in addressing these issues, many are still not fully equipped to manage the complex needs of patients with behavioral health concerns. The Advisory Board’s survey highlights that while more PCPs are screening for these conditions, they are often doing so without the necessary resources, training, or systems in place to provide adequate care. This creates a gap in care that can have serious consequences for patients who may not receive the timely treatment they need.
M Health Fairview: A Model for Integration
Some health systems are already taking steps to support PCPs in addressing behavioral health integration concerns. One such example is M Health Fairview, a health system in Minnesota that has pioneered the practice of co-locating mental health clinicians within primary care offices. By embedding master’s and doctorate-level clinicians within primary care settings, M Health Fairview ensures that patients can receive comprehensive care that addresses both their physical and behavioral health needs. This model allows for the early intervention and treatment of behavioral health conditions during routine visits, helping to prevent issues from escalating.
Despite the success of this model, the report reveals that access to embedded mental health staff is still limited. Only 25% of surveyed PCPs reported having embedded behavioral health integration professionals available to them. This highlights the need for greater integration of behavioral health services within primary care settings, as many providers simply do not have the support they need to offer comprehensive care. Other resources, such as referral guidance, medication prescribing tools, and on-demand expertise, have proven useful for PCPs, but they are not yet the norm in most healthcare settings.
The Training Gap: Addressing the Need for Education
One of the most significant barriers to providing effective behavioral health integration in primary care settings is the lack of ongoing training for PCPs. According to the Advisory Board’s report, half of the surveyed providers receive only 1 to 10 hours of behavioral health training each year, and 16% report receiving no training at all. This lack of education leaves many providers feeling ill-equipped to manage behavioral health conditions effectively. For example, the report found that 37% of PCPs feel uncomfortable prescribing medications for behavioral health issues, yet 85% of those same clinicians are still prescribing them.
The lack of confidence in prescribing behavioral health integration medications is a clear indication that PCPs need more robust training in this area. The Advisory Board’s report also found that 66% of PCPs expressed a desire for more training on behavioral health integration medications, which could help to improve their comfort and competence in prescribing these critical treatments. However, while training is essential, it is not a quick fix. Increasing access to education and resources will require significant investment and commitment from healthcare systems.
Geisinger’s Approach: Training Programs for Behavioral Health Care in Primary Care
Some health systems are already taking proactive steps to address the training gap. Geisinger, a health system based in Pennsylvania, has developed a fellowship program that aims to train advanced practitioners to deliver substance use disorder (SUD) care in primary care settings. This program, which was funded by a $2.8 million grant from the U.S. Health Resource and Service Administration, is designed to equip healthcare providers with the skills and knowledge needed to address SUDs, one of the most pressing behavioral health integration issues in the country.
A key component of Geisinger’s training program is education about medication-assisted treatment (MAT), which is used to treat opioid use disorder (OUD). The recent elimination of the X-waiver, which required prescribers to obtain additional certification to prescribe MAT, has made it even more crucial for providers to be well-versed in this treatment. Geisinger’s program helps to ensure that clinicians have the necessary knowledge and confidence to prescribe MAT and other behavioral health integration medications, even if they have not had prior training in this area.
The Path Forward: Enhancing Integration and Support for PCPs
The growing demand for behavioral health integration services has made it clear that primary care providers must be better equipped to address these concerns. While some health systems have taken steps to integrate behavioral health integration into primary care settings, much work remains to be done. For primary care to truly meet the needs of patients with behavioral health conditions, it will require a multifaceted approach that includes better training, more embedded staff, increased resources, and financial incentives for behavioral health integration screenings.
As the healthcare industry continues to move toward a more integrated model of care, the need for training and support for PCPs will only continue to grow. With the right resources and education, primary care providers can play a key role in addressing the behavioral health crisis and ensuring that patients receive the comprehensive, timely care they need. By bridging the gap between primary and behavioral health care, we can improve outcomes, reduce healthcare costs, and enhance the overall well-being of patients across the nation.
