Using a Continuum-based Framework to Implement Behavioral Health Integration in Primary Care Settings in New York State
Special Projects Fund
September 30, 2016
The need to integrate high-quality treatment and management of depression, anxiety, and other common behavioral health conditions into primary care has been well documented. Furthermore, most patients prefer receiving behavioral health treatment from providers with whom they already have an established relationship, such as their primary care providers.
However, integrating behavioral health into primary care practices remains a challenge because of the varying structures and sizes of these practices across the State. Through a review of best-practice integration models and substantial input from various experts and stakeholders, Montefiore Medical Center (Montefiore) developed a framework that delineates a series of steps that practices can take to integrate behavioral health services and track progress based on a practice’s available resources, size, and structure. In 2016, NYHealth awarded a grant to Montefiore, with co-funding from United Hospital Fund, to provide a practical implementation approach to integrating behavioral health services in primary care practices.
Under this grant, Montefiore tested the feasibility, utility, and implementation of the framework it developed to help primary care practices increase their ability to serve patients with mental health issues. Montefiore piloted the framework at four small and/or medium-size practices in upstate New York. Specifically, each participating practice used the framework to self-assess and develop appropriate goals and timelines. In addition, Montefiore provided targeted technical assistance early in the implementation process and continued to provide support and opportunities for collaboration through group and site-specific webinars every six months. Finally, Montefiore conducted an evaluation to assess the effectiveness of the framework approach, measure each practice’s progression, and determine whether integration of the framework resulted in improved identification and treatment of people with behavioral health disorders in primary care settings. Issue briefs and a final report were produced to summarize the project’s results and offer recommendations for use of the framework. Funds from United Hospital Fund were used to support a parallel pilot at four New York City-based primary care practices.