A comparison of primary care provider and behavioralist attitudes and beliefs about the integration of medical and mental health services in community clinics and health centers

The Integrative Behavioral Health Project (IBHP) is a funded study by The California Endowment to examine the integration of behavioral health services in primary care settings in California. Seven community clinic and health center demonstration sites were selected to participate. Each had a model of integration in which primary care providers (PCP) and behavioral health (BH) professionals were involved in the on-site coordination of care that may have included co-location of services, a warm handoff from PCPs to BH providers, and shared charting and documentation. Among the measures used was an on-line survey completed by providers that queried their respective perceptions about integration, including their assessment of the organization's present level of integration of services based on model developed by Miles, et al . PCPs, and BH staff were ask to assess five domains considered key to understanding the degree in which integration of behavioral health services occurred within their agency: communication, physical proximity of primary care and behavioral health care, temporal proximity to primary care and behavioral health care, integration of behavioral health expertise/services, and institutional stigma. More than 100 PCPs and BH staff completed the survey and ranked these domains from low to high, and commented on their rating. Statistically significant differences were found between provider groups and within subgroups based on education, length of practice, and specialty.