Integrating Primary Care into Behavioral Health Settings: What Works for Individuals with Serious Mental Illness

People with serious mental illness experience significant gaps in health care—and these gaps result in high rates of physical health conditions, shorter life expectancies, and higher health care costs. How can policymakers improve health care delivery so that it better serves patients with serious mental illness? For two decades, research has shown that behavioral health integration (BHI)—a patient-centered approach in which behavioral health and medical providers work together to provide care—can benefit patients with depression and anxiety disorder. Much less is known about behavioral health integration models that target people with serious mental illness.

Recognizing the gap in the research, the Reforming States Group (RSG) asked the Milbank Memorial Fund to prepare this report to better understand the evidence concerning the integration of primary care into behavioral health settings for this population. The RSG is a bipartisan, voluntary group of state health policy leaders from both the executive and legislative branches who, with a small group of international colleagues, work on practical solutions to pressing problems in health care.

The report assesses and synthesizes primary evidence sources over the last 10 years. It was developed by policymakers for policymakers, especially those seeking to develop policies and programs that support integration of physical health care into BHI settings. In particular, the report offers:

• A summary of outcomes from BHI models that target populations with serious mental illness and substance use disorder,
• Identification of BHI models supported by evidence and strategies for implementing these models,
• Technical assistance resources for integration efforts.