"We began the integration of behavioral health with changes in 2011 but did evolve further for 2014," says Apoorva Stull, spokeswoman for the National Committee for Quality Assurance, the organization that determines the level of PCMH recognition an organization receives.
In 2014, PCMH standards for behavioral health include disclosing to patients the scope of behavioral health services available at the PCP location and establishing at least one referral relationship with a behavioral health provider. Stull says on-site integration isn't required, but is rewarded in scoring.
Integration is a different approach than previous attempts at coordinating care through co-location, an improvement because the patient needing mental health help was referred to someone closer, often down the hall or at least in the same building, but co-location remains a treat-medical-issue-and-refer-mental-issue model.
Behavioral health integration means a psychologist, psychiatrist, licensed clinical social worker, or the like is available, sometimes immediately, to help a primary care physician and patient sort through the emotional response a patient may be having to a medical diagnosis.
Melissa Cormier, a licensed clinical social worker and clinical program manager for Maine Behavioral Healthcare, an integrated network of mental health providers serving patients in 11 counties across Maine, cites a recent example in one MBH's primary care clinics with a diabetic patient whose AIC levels were up significantly.