Montefiore Medical Center

Depression and anxiety are common among patients seen in primary care settings—and even more prevalent among patients with chronic diseases and pregnant patients. However, these behavioral health conditions frequently go unrecognized—and, when identified, are often treated ineffectively. The scarcity of behavioral health providers in the community, and the stigma often associated with such referrals, present additional challenges.

The result: ineffective treatment of common behavioral health problems, poor control of chronic physical health conditions, impaired parenting, avoidable health care utilization, and increased costs—especially for those with serious chronic disorders. It is a clinical and economic imperative to improve screening and evidence-based treatments, monitoring, and quality improvement approaches for these behavioral health conditions in primary care settings.

This project aims to identify, analyze, and describe evidence-based models of behavioral health integration that can be implemented in small to medium-sized practices, create a framework that outlines the component parts of integration, and develop a guide to assist these smaller practices in implementing the models. Project staff will also provide recommendations to the New York State Department of Health and Office of Mental Hygiene on ways to evaluate the progress of behavioral health integration in small to medium-sized primary care practices. It's a particularly timely project because Performing Provider Systems, under New York's Delivery System Reform Incentive Payment program, seek such integration of services.

Henry Chung, MD, a well-known expert in behavioral health integration, is serving as the project's director. Dr. Chung is vice president of the Care Management Organization of Montefiore Medical Center, medical director of the Montefiore Accountable Care Organization, and associate professor of clinical psychiatry at the Albert Einstein College of Medicine. Harold Pincus, MD, will provide consulting services. Dr. Pincus is professor and vice chair of the department of psychiatry and co-director of the Irving Institute for Clinical and Translational Research at Columbia University.

Sept. 1, 2015