behavioral health integration

Successful Behavioral Health and Primary Care Partnerships

I am happy to see that there are numerous initiatives underway to address the primary care needs of people with behavioral health disorders. It is heartwarming to see the silos begin to develop cracks, allowing the primary care folks and the behavioral health folks to engage in conversations about how we can work TOGETHER to serve this vulnerable population.

It isn’t easy for two disparate groups to work together.  It takes considerable planning!  Despite the fact that primary care and behavioral health are both healthcare fields, they have vast differences.  The culture, funding streams, philosophy, and overall approach to treatment vary greatly. Therefore, it is not an easy task for these two groups to establish a collaboration for serving the folks with behavioral health disorders….yet they are doing just that!  The mission is bigger than the differences! It is worthwhile to focus on ways to streamline the integration process.

For a successful behavioral health – primary care partnership, it is imperative to address these eight steps that were adapted from “Strategies to Preserve Public-Private Partnership ‘Best Practices’: Keys to Genuine Collaboration” by Greg Schmieg and Bob Climko, MD, Behavioral Health Management May/June1998. Vol. 18  No. 3:

    It is vital for both organizations to sit down together and create a shared vision. This will likely require a merging of goals into a partnership mission statement. This mission statement must be communicated with everyone involved in the partnership. The success of the partnership will depend on frontline champions.  They need to be identified and empowered from the onset. They will provide the energy to motivate other team members.
    Primary care and behavioral health speak different languages; therefore, a common language must be identified.  Clarity of communication enhances mutual understanding of cultures, roles, and expectations.  While these differences might not seem important at the onset, it will become increasingly important as the partnership progresses.  Most likely, each partner has a different language for many things. There are notable differences between contract deliverables, medical records,  coding, management structure, procedures, and even the language used in describing the clients/patients/consumers/members served.
    It is very important to temper expectations within the partnership. Establishing regular meetings will help to promote ongoing communication. Mutual goals and disappointments should be continually communicated so that they can be addressed immediately. The partners must remain flexible in order to sustain a healthy partnership.
    The decision makers must be open to new ideas and problem solving. Developing shared solutions maximizes organizational efficiency and capacity. Everyone must have skin in the game! Compromise is important for success.
    The project should first be piloted to allow for evaluation and for adjusting expectations to ensure that both partners are on the same page. Internal conflicts are inevitable and should be discussed openly.  The partners must address differences of opinions on an ongoing basis. Partnerships create an opportunity for enhanced outcomes through blending of resources to maximize the capacity of each organization.
    Face-to-face meetings are essential to establishing and maintaining trust among partners. Be sure to focus on building trust at all levels.  Face-to-face time creates a forum for maintaining checks and balances to ensure fidelity to the mission. Constantly solicit feedback from partners at all levels.
    Success is dependent on the involvement of everyone. This requires empowering champions at all levels to move the mission forward.  This empowerment develops buy-in among staff. Communicating with everyone and soliciting feedback ensures ongoing focus on the mission. Be sure to create a forum that allows both positive and negative feedback.
    Establish the outcomes to be measured early in the project. Be prepared to modify outcomes as needed. Don’t overlook the benefits of partnership that include more efficient allocation of resources, less duplication of services, increased choice among clients, and the synergistic effect of the partnership resulting in enhancing the lives of those we serve.

Following these eight steps helps to bridge the differences between behavioral health and primary care to ensure a successful partnership. Many partnerships have been derailed due to poor communication and lack of planning.  Careful preparation at the onset will ensure a productive partnership that will ensure a focused mission to address the health disparities among people with behavioral health issues.


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