Provider Perspectives on Integrating Primary and Behavioral Health: A Report from the High Plains Research Network

Article Figures & Data

Table 1. Demographics of High Plains Research Network Primary Care and Behavioral Health Provider Survey Respondents, 2011

Demographics	PCPs (n = 88)	BHPs (n = 49)
Age (years)
25–44	38 (43)	21 (43)
45–64	40 (45)	15 (31)
≥65	1 (1)	9 (18)
Refused	9 (10)	4 (8)
Sex
Male	38 (43)	14 (29)
Female	40 (45)	33 (67)
Refused	10 (11)	2 (4)
Race
White	62 (70)	42 (86)
Black	3 (3)	3 (6)
Asian	8 (9)	0 (0)
Hispanic/Latino	6 (7)	1 (2)
Other/refused	10 (11)	3 (6)
Practice type^*
Private	24 (27)	13 (27)
Public	8 (9)	0 (0)
For profit	6 (7)	7 (14)
Not for profit	8 (9)	9 (18)
FQHC	19 (22)	2 (4)
RHC	39 (44)	2 (4)
Other	3 (3)	7 (14)
Provider training/education
MD/DO	49 (56)	—
Physician assistant	10 (11)	—
Nurse practitioner	23 (26)	—
Psychiatrist	—	1 (2)
PhD/PsyD	—	2 (4)
MA/MS	—	19 (39)
LPC/PC	—	10 (20)
MSW	—	5 (10)
MFT	—	5 (10)
Other/missing	6 (7)	7 (15)

↵* Providers could choose all that apply.
BHP, behavioral health provider; PCP, primary care provider; FQHC, federally qualified health center; RHC, rural health center; MD, medical doctor; DO, doctor of osteopathy; PhD, doctor of philosophy; PsyD, doctor of psychology; LPC, licensed professional counselor; PC, professional counselor; MA, master of arts; MS, master of science; MSW, master of social work; MFT, marriage and family therapist.

Table 2. Primary Care and Behavioral Health Integration of Current Practice Site

Integration Status	PCPs (n = 88)	BHPs (n = 49)
No integrated BHP in practice	64 (73)	19 (39)
Thinking about integrating a BHP	1 (1)	6 (12)
In the process of integrating a BHP	2 (2)	12 (24)
Integrated BHP	21 (24)	11 (22)
Previously unsuccessful attempt to integrate BHP	1 (1)	0 (0)

Table 3. Ideas for Improving Primacy Care and Behavioral Health Integration in the High Plains Research Network

Idea	PCPs (n = 88)	BHPs (n = 49)	Odds Ratio (95% CI)	P
Improve access to BHPs	50 (57)	20 (41)	1.9 (0.9–3.8)	.07
Build an inpatient facility	30 (34)	15 (31)	1.2 (0.5–2.5)	.67
Colocate	15 (17)	25 (51)	0.2 (0.1–0.4)	<.001
Warm hand-offs	33 (38)	32 (65)	0.3 (0.1–0.7)	.001
Hire a case manager	37 (42)	18 (37)	1.2 (0.6–2.6)	.54
Shared visits	19 (22)	19 (39)	0.4 (0.2–0.9)	.03
Improve PCP training	25 (28)	25 (51)	0.4 (0.2–0.8)	<.01
Improve referral process	58 (66)	23 (47)	2.2 (1.1–4.5)	.03
Nothing	2 (2)	2 (4)	0.5 (0.1–4.0)	.62

Data are n (%) unless otherwise indicated.
BHP, behavioral health provider; CI, confidence interval; PCP, primary care provider.

Table 4. Barriers to Primary Care and Behavioral Health Integration

Barrier	PCP (n = 88)	BHP (n = 49)	Odds Ratio (95% CI)	P
No champion	18 (20)	12 (24)	0.8 (0.3–1.8)	.58
Lack of payment for BHP	54 (61)	18 (37)	2.7 (1.3–5.6)	<.01
Limited resources to develop BHP services	38 (43)	15 (31)	1.7 (0.8–3.6)	.15
No community support	12 (14)	16 (33)	0.3 (0.1–0.8)	<.01
PCP recruitment	19 (22)	7 (14)	1.6 (0.6–4.3)	.29
PCP retention	22 (25)	6 (12)	2.4 (0.9–6.4)	.08
BHP recruitment	46 (52)	11 (22)	3.8 (1.7–8.3)	<.001
BHP retention	46 (52)	14 (29)	2.7 (1.3–5.8)	<.001

Data are n (%) unless otherwise indicated.
BHP, behavioral health provider; CI, confidence interval; PCP, primary care provider.

Table 5. Level of Agreement That Integration of Primary Care and Behavioral Health in Community is an Achievable Goal