Table 1. Observed Differences between Traditional Mental Health and Integrated Primary Care
Traditional Mental HealthIntegrated Behavioral Health and Primary Care
50-min appointmentsBrief, targeted interventions (5 to 30 min)
Asynchronous communication with other healthcare stakeholders (eg, fax a note, voice message)Immediate communication with other members of the team: directly or within the shared EHR
Interventions often focused on mental healthInterventions focused on behavioral health: mental health, substance use, life stressors, health behaviors, and adherence to medical regimens
Clinical involvement often long term, likely to take a reflective approachClinical involvement focused on the moment (eg, problem and/or solution), likely to take a more active and teaching approach
Patients discharged following completion of carePatients retained in the EHR as long as they are receiving primary care
Documentation often in narrative form: focused on telling the person's history and storyDocumentation often brief, focused on problem, intervention, and plan, and located either in separate note or imbedded in physicians' notes
Must document development of thorough knowledge of clientKnowledge of patient developed by PCP in previous relationship
Assign clinical diagnosis to billDiagnosis often resisted or delayed to try to help the patient without a label
Individuals referred to as “clients,” “consumers,” or other term designed to reduce stigmaIndividuals referred to as “patients” or “consumers”
  • EHR, electronic health record.