Effectiveness of Integrated Primary and Behavioral Healthcare

Abstract

A meta-analysis was completed to identify the degree of effectiveness of the integrated primary and behavioral healthcare (IPBH) paradigm for decreasing commonly occurring mental health symptoms. A systematic search strategy yielded 36 randomized controlled trials whose treatment effects were synthesized using statistical procedures to account for error associated with participant and study characteristics. Findings indicated that IPBH was superior to treatment as usual at end-of-treatment (g = −0.38 to −0.24; k = 39) and longest follow-up intervals (g = −0.40 to −0.24; k = 29). Moderator analyses revealed that number of treatment team providers and number of behavioral health sessions integrated into IPBH were the strongest predictors of treatment effect. Our findings support the position that mental health counselors are well suited to enhance the mental health of individuals within primary care settings. Suggestions are provided for promoting best practices and magnifying treatment effect.

Meta‐Analysis of Integrated Primary and Behavioral Health Care Interventions for Treating Substance Use Among Adults

“…This study was specific to adults receiving IPBH and tracking reductions in substance use. Our findings contrast those of Lenz et al (2018) and Asarnow, Rozenman, Wiblin, and Zeltzer (2015), who investigated more general behavioral health outcomes. Lenz et al conducted a meta-analysis evaluating mental health outcomes related to IPBH in primary care settings.…”

“…IPBH treats both the physical and psychological aspects of substance use disorder, which may increase the prevalence of patients being treated holistically who have previously gone untreated (Shin et al, ). Within the framework of treating substance use, substance abuse counselors collaborate with medical professionals to address the physical and mental health care needs of patients within the primary health care setting (Lenz, Dell'Aquila, & Balkin, ). Cooperation with a physician may be needed to assess the patient for detoxification, provide medication for withdrawal symptoms, and observe the patient while on the medication.…”

“…A subgroup effect was found, in that those who struggled with alcohol dependence had fewer issues with alcohol while participating in the CCM program. Lenz et al () conducted a meta‐analysis evaluating mental health outcomes related to IPBH in primary care settings. An evaluation of 14,764 participants yielded an effect size of –0.31, indicating IPBH to be more effective than standard medication and/or referral for participants with mental health problems.…”

“…health care needs of patients within the primary health care setting (Lenz, Dell'Aquila, & Balkin, 2018). Cooperation with a physician may be needed to assess the patient for detoxification, provide medication for withdrawal symptoms, and observe the patient while on the medication.…”

Pain intensity and mental health quality of life in veterans with mental illnesses: the intermediary role of physical health and the ability to participate in activities

“…This suggests that veterans are more willing to initiate self-managed interventions for chronic pain in general. Self-managed interventions can also be implemented through more direct ways through integrated primary and behavioral health care, see e.g., [ 43 ].…”