Preparing the Workforce for Behavioral Health and Primary Care Integration
Open accessAbstract
PURPOSE: To identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. METHODS: Observational cross-case comparison study of 19 U.S. practices, 11 participating in Advancing Care Together, and 8 from the Integration Workforce Study. Practices varied in size, ownership, geographic location, and experience delivering integrated care. Multidisciplinary teams collected data (field notes from direct practice observations, semistructured interviews, and online diaries as reported by practice leaders) and then analyzed the data using a grounded theory approach. RESULTS: Organizations had difficulty finding clinicians possessing the skills and experience necessary for working in an integrated practice. Practices newer to integration underestimated the time and resources needed to train and organizationally socialize (onboard) new clinicians. Through trial and error, practices learned that clinicians needed relevant training to work effectively as integrated care teams. Training efforts exclusively targeting behavioral health clinicians (BHCs) and new employees were incomplete if primary care clinicians (PCCs) and others in the practice also lacked experience working with BHCs and delivering integrated care. Organizations' methods for addressing employees' need for additional preparation included hiring a consultant to provide training, sending employees to external training programs, hosting residency or practicum training programs, or creating their own internal training program. Onboarding new employees through the development of training manuals; extensive shadowing processes; and protecting time for ongoing education, mentoring, and support opportunities for new and established clinicians and staff were featured in these internal training programs. CONCLUSION: Insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
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Most BHPs have not received in-depth training prior to entering IPC.
“most BHPs have not received in-depth training prior to entering this unique setting (Hall et al., 2015; Serrano et al., 2018).”
From Barriers to and Facilitators of Using Evidence-Based, Cognitive–Behavioral Anxiety Interventions in Integrated Primary Care Practice (2023) · cites this paper as Hall et al., 2015
Our results are consistent with prior work indicating that BHPs working in IPC benefit from extensive onboarding and training to increase their comfort and competence in practicing within IPC models of service delivery.
“Our results are consistent with prior work indicating that BHPs working in IPC benefit from extensive onboarding and training to increase their comfort and competence in practicing within IPC models of service delivery (Dobmeyer et al., 2016; Hall et al., 2015).”
From Barriers to and Facilitators of Using Evidence-Based, Cognitive–Behavioral Anxiety Interventions in Integrated Primary Care Practice (2023) · cites this paper as Hall et al., 2015
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- Authors
- Hall, J., Cohen, D. J., Davis, M., Gunn, R., Blount, A., Pollack, D. A., Miller, W. L., Smith, C., Valentine, N., & Miller, B. F.
- Affiliations
- Oregon Health & Science University (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2015-09-01
- Volume
- 28
- Issue
- Supplement 1
- Pages
- S41-S51
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- PMC
- PMC7324072
- OpenAlex
- W2191639308
- Cited by
- 99
- References
- 29
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 3 · 2019: 14 · 2018: 24 · 2017: 11 · 2016: 7 · 2015: 5
- FWCI
- 28.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- Colorado Health Foundation (CHF-3848)
- Maine Health Access Foundation (2012FI-0009)
- Agency for Healthcare Research and Quality (K12HS022981)
- U.S. Public Health Service (8846.01-S01)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- integrated care teams, clinician training, employee training, organizational socialization, internal training programs, mentoring, barriers to integration, primary care practices
- MeSH terms
- Mental Disorders, Community Mental Health Services, Humans, Inservice Training, Personnel Selection, Practice Management, Medical, Primary Health Care, United States, Delivery of Health Care, Integrated, Needs Assessment
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