The term behavioral health has gained exposure and popularity more recently, particularly among medical providers and those involved in healthcare reform in the United States. Burg & Oyama1 define behavioral health as, “the psychosocial care of patients that goes far beyond a focus on diagnosing mental or psychiatric illness… [encompassing] not only mental illness but also factors that contribute to mental well-being”. This is the first of a series of articles which will introduce essential concepts and goals for integrated behavioral health treatment. Why is this important? The correlation between comorbid mental health and medical issues has mounting evidence for impacting healthcare cost, treatment outcomes, and patient satisfaction. Comorbidity in this sense refers to the presence of two co-occurring issues influencing the progression and prognosis of either condition. Well researched comorbid conditions include diabetes & depression2, asthma & anxiety/panic3, and chronic pain & psychosocial issues4. The good news is we are learning innovative ways to effectively treat comorbid conditions concurrently, thereby increasing the likelihood of successful outcomes and improved quality of life for patients.
The sustainable future of healthcare in the U.S. will likely require efforts to improve consultation/communication, cross-discipline competency, and collaboration among clinical teams. Traditionally, mental health specialists (i.e. psychologists, LMFTs, LCSWs, LPCs, CMHCs, etc.) have operated in relative isolation from the medical community. Aside from psychiatrists, who are primarily trained as Medical Doctors (MD), many practicing psychotherapists have minimal training in the biomedical model of treatment. And the inverse is true as well, wherein medical practitioners often have limited understanding of psychotherapeutic theory, psychosocial problem etiology, and effective behavioral intervention. This is exceptionally problematic for the patient because practitioners involved in treatment may have dramatically different, and often conflicting, beliefs about mental health problems and their respective solutions. Sperry5 suggests, “the goal of health care integration is to position the behavioral health counselor to support the physician… bring more specialized knowledge… identify the problem, target treatment, and manage medical patients with psychological problems using a behavioral approach”. The future of medicine may very well be found in systems which prioritize such supportive collaboration, encourage patient-centered policy, and deliver on whole-person treatment options.
Hopefully this educational introduction to behavioral health integration can serve as a starting point for further interest and exploration of the topic. While this is a relatively new concept, I predict we will see a dramatic increase of integrative efforts emerge over the next several years as clinicians, administrators, policy makers, and third-party payers (i.e. insurance companies) recognize the cost-effectiveness and clinical efficacy of interdisciplinary collaboration. We do not live our lives in a vacuum, and our problems are rarely isolated conditions in themselves. Therefore, we will need innovators across various disciplines to create efficient and effective systems which benefit all parties involved with the daunting task of healthcare reform. As patients, we can empower ourselves with education about how the biopsychosocial model might positively influence our role and options in treatment. So, the next time you are at the doctor’s office and they ask you questions about mood and/or behaviors, and you think, “What does this have to do with my medical problem?”, now you’ll know.
1.Burg, M.A., & Oyama, O. (2016). The behavioral health specialist in primary care: Skills for integrated practice. New York, NY: Springer Publishing Company.
- de Groot, M., Golden, S.H., & Wagner, J. (2016). Psychological conditions in adults with diabetes. American Psychologist, 71(7), 552-562.
- Ritz, R.,Meuret, A., Trueba, A.F., Fritzche, A., & von Leupoldt, A. (2013). Psychosocial factors and behavioral medicine interventions in asthma. Journal of Consulting and Clinical Psychology, 81(2), 231-250.
- Gatchel, R.J.,McGeary, D.D., McGeary, C.A., & Lippe, B., (2014). Interdisciplinary chronic pain management. American Psychologist, 69(2), 119-130.
- Sperry, L. (2014). Behavioral health: Integrating individual and family interventions in the treatment of medical conditions. New York, NY: Routledge.