Building Healthier Teams: Integrating Behavioral Health Without Building New Walls

Expanding Integrated Behavioral Health in Primary Care (IBHPC) requires careful coordination of physical space, staffing models, and workflow integration. Co-locating behavioral health professionals within primary care offices facilitates warm handoffs between providers, allowing patients to see a behavioral health clinician on the same day as their medical appointment. This not only reduces the burden of navigating separate systems but also increases the likelihood that patients will follow through on care recommendations. Studies have shown that co-located care leads to improved behavioral health outcomes and greater patient satisfaction compared to referral-only models¹.

Effective IBHPC models rely on interdisciplinary teams that include primary care providers, behavioral health clinicians, care coordinators, and sometimes psychiatric consultants. Regular team huddles, shared electronic health records, and clear communication protocols are essential for ensuring that care is seamless and patient-centered. Health systems that invest in training staff to understand each other's roles and responsibilities can reduce duplication of services and improve clinical decision-making². For municipal leaders and clinic administrators, this means prioritizing infrastructure that supports shared documentation systems and allocating time for cross-disciplinary collaboration.

Reducing Stigma and Increasing Patient Engagement

One of the key advantages of integrating behavioral health into primary care is the reduction of stigma associated with seeking mental health services. Patients may feel more comfortable discussing behavioral health concerns in a familiar medical setting, especially when these services are presented as part of holistic care rather than as separate or specialized interventions. Research indicates that when behavioral health is framed as a routine part of primary care, patients are more likely to accept and engage with treatment³.

Providers can further reduce stigma by using patient-centered communication strategies that normalize mental health discussions. For example, asking all patients standardized screening questions for depression or anxiety during intake can signal that such concerns are a standard part of health care. Clinics should also consider branding their behavioral health services in a way that emphasizes wellness and resilience rather than illness. This approach has proven effective in increasing service utilization, particularly among populations that may be hesitant to seek traditional mental health care, including older adults and communities of color⁴.

Financing and Sustainability Strategies for IBHPC

Sustainable implementation of IBHPC requires financial models that support integrated services. Traditional fee-for-service reimbursement models often fail to adequately cover behavioral health consultations, especially brief interventions delivered by licensed clinical social workers or psychologists within primary care. To address this, some health systems have transitioned to value-based payment models that reward outcomes rather than volume of services. For example, the Centers for Medicare & Medicaid Services (CMS) offers billing codes for collaborative care management that allow providers to receive reimbursement for psychiatric consultation and care coordination activities⁵.

Municipal and county health departments can play a role by leveraging local funding sources or grants to pilot IBHPC initiatives. For instance, several jurisdictions have used Mental Health Services Act (MHSA) funds or opioid settlement dollars to embed behavioral health clinicians in high-need primary care settings. Partnering with fede