Behavioral and Mental Health Integration into Primary Care Practice

• BHI Collaborative – Eight leading societies (5 primary care societies, 2 psychiatric societies, led by the AMA) established the BHI Collaborative to cultivate effective and sustainable integration of behavioral and mental health care into primary care practices. (The member groups are: AMA, ACP, AAFP, AAP, ACOG, AOA, APA, and ASCAP.) 
  • Compendium – The BHI Compendium is a tool to help physicians understand BHI and how to make it effective for your practice and patients. The goal is to provide accessible, detailed information on the steps required to integrate behavioral health care into your practice along with direct links to relevant resources for more specific information. 
  • Overcoming Obstacles Webinar Series – The BHI Collaborative created this webinar series covering a variety of topics to help practices tackle different aspects of integrating behavioral health into primary care. 

• Waco Guide – This psychopharmacology tool was created by Waco Family Medicine in consult with the Massachusetts General Hospital Psychiatry Academy. Also available in an smartphone app, the Waco Guide is intended to guide decisions regarding psychopharmaceutical treatment of common psychiatric conditions seen in adult and pediatric primary care (e.g., depression, anxiety, ADHD, substance use disorders, PTSD, eating disorders, etc.). 
• AIMS Center – This website from the University of Washington in Seattle offers a wealth of information to help practices integrate mental health services into primary care practice, including role-based tools, screening instruments, videos, patient materials, billing and coding guidance, registries, and implementation support.  
  • Office Hours - Seasoned coaches and experts answer questions and provide guidance regarding collaborative care, staff training, registry tools, and whatever implementation hurdles physician practices are encountering. These calls are open-ended and you can can call at any time during the hour. 
    • Implementation Office Hours – 3rd Thursday of each month (10 PT/11 MT/12 CT/1 ET) 
    • Finance Office Hours – 1st Wednesday of each month (9 PT/10 MT/11 CT/12 ET) 
  • Financial Modeling Workbook – This downloadable workbook can help practices model and estimate revenue and expenses for providing integrated behavioral health services (free with registration). 
• Zero Suicide Toolkit - This website includes CME activities, safety planning, assessment toolkits, and training and other resources that you can use for your practice.

• How-To Guides: 
  • Substance Use Disorder How-to Guide 
  • Suicide Prevention How-to Guide
  • Psychopharmacology How-to Guide 
• Workflow Guides: 
  • Workflow Plan Resource   
  • BHI Workflow Examples   
  • Warm Handoff Script  
• StepsForward BHI Module – This module can help identify which model is best for your practice. 

• From Annals of Internal Medicine: 
  • Factors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States – A qualitative study from Annals of Internal Medicine  
  • The Challenges of BHI: The Persistence of the Mind-Body Problem
• Integrating Behavioral Health into Primary Care (Family Practice Management, May-June 2021) 
• COVID-19 has led to a sharp increase in depression and anxiety (Economist, October 11, 2021) 

• ACP Letter to Senate Finance Committee on Tele-Mental Health Draft Legislation (June 2022)
• ACP Statement to Energy and Commerce Committee Regarding Mental and Behavioral Health Legislation (April 2022)
• ACP Statement to Ways and Means Committee on America's Mental Health Crisis (February 2022)
• Advocacy Toolkit: Modernizing License and Credentialing Applications to Not Stigmatize Mental Health
• Improved access to mental, behavioral, and substance use care services – ACP responded to a request for information from the Senate Finance Committee regarding bipartisan legislation. 
• The Integration of Care for Mental Health, Substance Abuse, and Other Behavioral Health Conditions into Primary Care - This ACP policy paper discusses how better integration of behavioral health in the primary care setting can improve care of patients with mental and substance use conditions. The paper examines various approaches to integration and offers policy recommendations.

Sustaining behavioral healthcare in your practice

This series of webinars was developed collaboratively by representatives of the 8 participating organizations. Most webinars include both primary care and psychiatric clinicians in a wide variety of settings, including small practices, and all provide practical, actionable strategies to help primary care practices sustain a collaborative and equitable approach to providing whole-person care to their patients. 

Future and past events 

• Cvent Registration webpage 
• Behavioral Health Integration Overcoming Obstacles YouTube Playlist  
• Some webinars are available in podcast form on the AMA’s Moving Medicine channel (and available on Apple Podcasts). 

Why BHI

• The Value of Collaboration and Shared Culture in Behavioral Health Integration – Physician experts provide insight on how and why primary care and mental health can work together (58 min) 
• Physicians Leading the Charge: Dismantling stigma around behavioral health conditions and treatment – The speakers share examples of how all clinicians on the care team can break the stigma barrier and normalize mental health treatment. (61 min) 
• Beating Physician Burnout with Behavioral Health Integration – This webinar relates how BHI has helped increase joy in practice and clinician satisfaction. (32 min) 
  • Podcast 
• Advancing Health Equity through BHI – This webinar focuses on how BHI can address disparities that affect racial, ethnic, and other populations. (60 min) 
• Effective BHI Strategies for Independent Practices – Clinicians from small, independent practices share how they got started and how they overcame barriers. (62 min) 
  • Podcast 
• Shadow Pandemic: Mental Health Impacts of COVID-19 on Patients and Care Teams - Experts discuss the impacts on physicians and the care team, challenges encountered, and solutions used to creatively address patient needs since the pandemic. (44 min)

Implementation

• Engaging Patients in Psychosocial Interventions - Explore skills and tools for physicians to deliver evidence-based interventions (e.g., motivational interviewing, shared decision making, and psychoeducation) within a single patient appointment. (47 min)"
• Integrating Psychopharmacology into Primary Care: When and How - Experts explore available tools and resources to help primary care physicians determine best interventions to address behavioral health conditions. (31 min)
• Non-pharmacological services and treatments - This webinar explores how two physician practices use behavioral health specialists to expand access and treatment to patients with behavioral health conditions. One pediatrician discusses how her practice has improved mental health care for their low-income population and an internist discusses patients with substance use disorders. (30 min).
• Establishing Efficient Workflows – Physician experts share how they established workflows and “warm handoffs” for patients and the care team. (30 min) 
  • Podcast 
• Keys to Success: Implementation Strategies for Virtual Behavioral Health Integration – This webinar explores the use of telehealth to support behavioral health of patients. (61 min) 
• Privacy and Security: Communication of Behavioral Health Information – Experts review privacy, security, and what is permissible under current laws and regulations, including examples of how to safely integrate patient care while protecting patient privacy (63 min) 
• Assembling the BHI Care Team: Roles and Responsibilities – Experts share tips on how to identify practice needs, train care team members and assign roles and responsibilities for addressing patient behavioral health needs in a streamlined way. (49 min)

Special Populations

• Bolstering Chronic Care Management with BHI – Patients with chronic diseases are particularly prone to mental and behavioral health issues. This webinar highlights the role BHI plays in providing whole-person care. (59 min) 
• Practical Strategies for Managing Suicidal Ideation and Reducing Risk – This webinar provides tips on how to implement suicide screening and prevention and what to do after a positive screen.(32 min)
• Addressing Adult Suicidal Ideation in the Primary Care Setting – Building off the previous webinar, experts provide practical implementation strategies and one practice's lessons learned. (40 min)
• How to Address the Growing Behavioral Health Concerns Among Children, Adolescents, and Families – Pediatric specialists share how they use BHI to provide whole-person care to children, adolescents, and their families (55 min) 

Billing and Financial Sustainability

• Measuring the Financial Impact of BHI – This webinar explores how practices can plan for and sustain BHI in both FFS and value-based care arrangements. (67 min) 
• Behavioral Health Billing and Coding 101: How to Get Paid – This webinar provides an overview of billing for behavioral and mental health services across the spectrum from co-located to collaborative care, including CPT codes, services, and reporting requirements. (60 min) 
• Practical Billing Strategies for the Collaborative Care Model – This webinar takes a deeper dive into billing and coding strategies specific to the Collaborative Care Model. (42 min) 
• Fostering Effective Health Plan- Physician Partnerships – In this case study from Michigan, a major payer and a health system share their experience launching a successful BHI program. (39 min)