Primary care providers (PCPs) are often the first point of contact for individuals seeking help with mental health or behavioral concerns. Yet many PCPs find themselves without the tools, resources, or infrastructure to fully support these needs. As the healthcare system evolves toward more holistic and patient-centered models, Integrated Behavioral Health in Primary Care is becoming not just a goal—but a necessity.
Why Integration Matters
During a recent Bipartisan Policy Center webinar, Melissa Merrick, Executive Vice President of Primary Care Services at Southcentral Foundation, stated, “Primary care is behavioral health.” In fact, a large percentage of patient concerns presented in primary care settings—from sleep issues and stress to substance use and chronic disease management—are directly tied to behavioral health.
Despite this overlap, the systems supporting these services have often operated in silos. Integrated Behavioral Health in Primary Care seeks to bridge these gaps by fostering collaborative, team-based models of care that address both physical and mental health needs simultaneously.
The Barriers Facing Busy Providers
One of the biggest challenges to implementing Integrated Behavioral Health in Primary Care is the sheer workload placed on PCPs. Between short appointment windows, administrative tasks, and high patient volume, many providers lack the capacity to incorporate behavioral health services meaningfully into their practices.
Even with strong motivation, change can be slow. “When we started, there wasn’t really anybody, myself included, who had been trained in integrated behavioral health,” Merrick noted. “We had to develop an on-the-ground training program that spoke to our clinic.”
Building a Workforce That Can Sustain Integration
Expanding Integrated Behavioral Health in Primary Care requires a skilled, adaptable workforce. Yet the healthcare field is already grappling with a shortage of professionals trained in behavioral health. Education and training programs are essential, but they must be supported with time, funding, and long-term system-level reinforcement.
“You have to create a healthcare system that reinforces those skills when people are done with their training,” said Dr. Atul Grover, Executive Director of the AAMC Research and Action Institute. “Otherwise, we can put out 30,000 perfect physicians every year, but if the system beats that practice out of them, then we haven’t gained ground.”
HRSA grants and similar programs that fund integration training could accelerate adoption, especially if they include incentives to embed behavioral health specialists into primary care teams.
Government Support and Policy Models
Government initiatives are beginning to align with this movement. The Center for Medicare & Medicaid Services Innovation Center’s (CMMI) Primary Care Model, for example, aims to promote value-based, whole-person care. But according to experts like Dr. Andy Keller, President and CEO of Meadows Mental Health Policy Institute, more rigor and specificity are needed.
“The problem is, most people doing integrated care are not rigorously doing integrated care,” Keller said. Instead of evidence-based models like collaborative care—which rely on shared registries and measurement-based outcomes—many practices are simply co-locating services with minimal communication between providers.
To make Integrated Behavioral Health in Primary Care effective, Keller emphasized the need for actionable standards, such as behavioral health integration plans and accountability in total-cost-of-care frameworks.
The Role of Non-Clinical Staff in Integration
Another powerful yet underutilized asset in this movement is non-clinical staff, particularly peer support workers. Including peer counselors and community health workers in care teams can rapidly expand capacity while also building community trust.
“If you include non-masters-trained professionals, such as peer counselors, then you’re talking about one million people that deliver some type of mental health care,” Grover noted. These workers can offer culturally relevant support, address stigma, and act as bridges between clinical systems and underserved populations.
“Access is trust,” said Merrick. “It’s how we build relationships and start health behavior change. Non-clinical workers have a huge role in quality of care and expanding the workforce.”
Flexible Models for Real-World Practice
Ultimately, the success of Integrated Behavioral Health in Primary Care lies in adaptability. Every health system has unique constraints—from geography to funding to workforce availability. That means a one-size-fits-all solution is unrealistic.
“Every system is going to have to adapt a model a little bit to what works for their system,” Merrick said. The goal is to stay faithful to the evidence-based principles of integrated care, while remaining responsive to local realities.
Looking Ahead: Prioritizing Whole-Person Health
As public and private sectors align on the importance of behavioral health integration, Integrated Behavioral Health in Primary Care will become a defining feature of modern healthcare. From better outcomes and reduced healthcare costs to improved provider satisfaction and equity in access, the benefits are clear.
However, progress will require more than good intentions. It will take collaboration, investment, and a willingness to break down traditional barriers between mind and body, provider and patient, clinical and non-clinical roles.
In a healthcare landscape that increasingly values outcomes over volume, Integrated Behavioral Health in Primary Care represents not just a trend—but a transformational shift toward holistic, equitable care for all.
