DARTNet Institute Informing Practice Improving Care
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Research > Integrating Behavioral Health and Primary Care

Integrating Behavioral Health and Primary Care

Benjamin Littenberg, MD (University of Vermont and State Agricultural College), Principal Investigator

DARTNet's role: managing all EHR data as well as patient consent

Project Overview: Behavioral health includes mental health care, substance abuse care, health behavior change, and attention to family and other psychological and social factors. Many people with behavioral health needs present to primary care and may be referred to mental health or substance abuse specialists, but this method is often unacceptable to patients. Two newer ways have been proposed for helping these patients. In co-location, a behavioral health clinician (such as a psychologist or social worker) is located in or near the primary practice to increase the chance that the patient will make it to treatment. In Integrated Behavioral Health (IBH), a behavioral health clinician is specially trained to work closely with the medical provider as a full member of the primary treatment team. Although it is clear that the current system is not acceptable, we donít know which of the two new ideas is best.

The research question is: Does increased integration of evidence-supported behavioral health and primary care services, compared to simple co-location of providers, improve outcomes? The key decisions affected by the research are those made at the practice level: whether and how best to use behavioral health services. For patients, whether to seek out or accept offered behavioral health services will be influenced by the manner they are made available.

This study includes 30 practices that will each start off using co-location. Over time, each one will convert to IBH using a practice improvement method that has helped in other settings. The health status of patients in each practice will be measured before and after they start using IBH. From each practice, 60 patients with behavioral health needs will be randomly selected for a total of 1,800 patients followed for five years.



Grant is funded by the Patient-Centered Outcomes Research Institute (PCORI) for a total of $18,509,211 over 5 years.