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Internists Call for Better Integration of Behavioral Health Into Primary Care Setting

ACP Position Paper Offers Six Recommendations

(Washington, June 30, 2015)- The American College of Physicians (ACP) today called for better integration of behavioral health into primary care when it released its latest position paper, "The Integration of Care for Mental Health, Substance Abuse and Other Behavioral Health Conditions into Primary Care: American College of Physicians Position Paper." A summary of the paper is in today's Annals of Internal Medicine online edition.

"The policy paper provides an environmental scan of the current state of conditions included in the concept of behavioral health and examines the arguments for and barriers to increased integration of behavioral health within the primary care setting," said Wayne J. Riley, MD, MPH, MBA, MACP, president of ACP. "The paper examines various approaches of delivering integrated care and offers a series of policy recommendations based on the reviewed information and evidence to inform actions of the College and its members regarding advocacy, research, and practice."

ACP calls for:

  • integration of behavioral health care into primary care and encourages its members to address behavior health issues within the limits of their competencies and resources.
  • public and private health insurance payers, policymakers, primary care physicians, psychiatrists, clinical psychologists and other behavioral health care professionals should work toward removing payment barriers that impede behavioral health and primary care integration. Stakeholders should also ensure the availability of adequate financial resources to support practice infrastructure required to effectively provide such care.
  • federal and state governments, insurance regulators, payers and other stakeholders should address behavioral health insurance coverage gaps that are barriers to integrated care. This includes strengthening and enforcing relevant non-discrimination laws.
  • increased research to define the most effective and efficient approaches to integrate behavior health care within the primary care setting.
  • federal and state governments, relevant training programs, and continuing education providers to ensure an adequate workforce to provide for integrated behavioral health care in the primary care setting.
  • all relevant stakeholders initiate programs to reduce the stigma associated with behavioral health.

These programs need to address both negative perceptions held by the general population as well as those held by many physicians and other health care professionals.

"There are many areas related to behavioral health that were not addressed in this paper and are no less important to our members, the patients they treat and society in general. This includes ensuring the delivery of good primary care within specialized behavioral health treatment settings-the home for care for many patients with serious mental illness or substance abuse problems," Dr. Riley emphasized. "Other related areas, which ACP has already addressed in policy statements, include efforts to decrease prescription drug abuse, the acceptance of substance abuse as a public health rather than a criminal issue , and the relationship of behavioral health issues to ensuring firearm safety."

The ACP paper noted that physicians and other health care professionals will have to consider the behavioral and physical health of the patient if they are to be treated as a "whole person." Most patients with behavioral health needs use the primary care office as their main source of care and given the nation's shortage of behavioral health providers, this may be the only setting in which behavioral health can be broadly recognized and treated. Changes to the health care delivery system, payment models, education and training, health insurance coverage, and societal and cultural perceptions are necessary to encourage communication and integration among the behavioral and physical health disciplines.

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The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

Contact: David Kinsman, (202) 261-4554
dkinsman@acponline.org