The Case for Behavioral and Physical Health Integration

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The Bree Collaborative workgroup has recently developed recommendations for the Washington State Health Care Authority on how to best integrate behavioral and physical health by 2020. Beginning last April, the group looked “at how mental illness and substance use disorders, together called behavioral health, are common and often go untreated due to stigma, lack of screening, and lack of access to appropriate care. We discussed how integrating behavioral health care into primary care, and primary care into behavioral health care has been proposed as a solution, but that in our state and across the country integration has been variable and inconsistent.”

Working from a clear definition of “ integrated behavioral health care” and “available evidence and existing models”, the Bree Collaborative workgroup created “eight common elements that outline a minimum standard of integrated care,” meant to bridge the varying systems and approaches used across the country. The eight elements include:

  • Integrated Care Team
  • Patient Access to Behavioral Health as a Routine Part of Care
  • Accessibility and Sharing of Patient Information
  • Practice Access to Psychiatric Services
  • Operational Systems and Workflows to Support Population-Based Care
  • Evidence-Based Treatments
  • Patient Involvement in Care
  • Data for Quality Improvement

The workgroup’s report also includes recommendations for employers who are seeking to lower health-related costs and increase worker productivity.

Delaware’s goal is to be in the top 10 percent of states for healthcare quality and patient experience. Central to this aim is the idea that health care delivery must be integrated, team-based, and patient-focused, with primary care physicians positioned as the “medical home” to ensure quality of care and control costs. DCHI’s Clinical Committee is designed to assist clinical practices in achieving greater efficiencies and improved outcomes for patients, and the integration of primary care and behavioral health is one its five core focus areas. For more information about how DCHI and the Clinical Commitee are supporting clinical staff with practice transformation, please visit us at

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