Table 1. Observed Differences between Traditional Mental Health and Integrated Primary Care

Traditional Mental Health	Integrated Behavioral Health and Primary Care
50-min appointments	Brief, 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 health	Interventions 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 approach	Clinical involvement focused on the moment (eg, problem and/or solution), likely to take a more active and teaching approach
Patients discharged following completion of care	Patients 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 story	Documentation 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 client	Knowledge of patient developed by PCP in previous relationship
Assign clinical diagnosis to bill	Diagnosis 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 stigma	Individuals referred to as “patients” or “consumers”