Alexander Blount

The Economics of Behavioral Health Services in Medical Settings: A Summary of the Evidence

The health care system in the United States, plagued by spiraling costs, unequal access, and uneven quality, can find its best chance of improving the health of the population through the improvement of behavioral health services. It is in this area that the largest potential payoff in reduction of morbidity and mortality and increased cost-effectiveness of care can be found. A review of the evidence shows that many forms of behavioral health services, particularly when delivered as part of primary medical care, can be central to such an improvement. The evidence supports many but not all behavioral health services when delivered in settings in which people will accept these services under particular administrative and fiscal structures.

THE DEVELOPMENT OF JOINT PRINCIPLES: INTEGRATING BEHAVIORAL HEALTH CARE INTO THE PATIENT-CENTERED MEDICAL HOME

The world of primary care was galvanized in 2007 by the publication of the Joint Principles of The Patient-Centered Medical Home (PCMH) that spells out the fundamental features of a primary health care setting in which a team of clinicians offers accessible first-contact primary care.[1][1] This

Joint principles: integrating behavioral health care into the patient-centered medical home.

The Patient-centered Medical Home (PCMH) is an innovative, improved, and evolving approach to providing primary care that has gained broad acceptance in the United States. The Joint Principles of the PCMH, formulated and endorsed in February 2007, are sound and describe the ideal toward which we

Joint principles: Integrating behavioral health care into the patient-centered medical home

The Patient-centered Medical Home (PCMH) is an innovative, improved, and evolving approach to providing primary care that has gained broad acceptance in the United States. The Joint Principles of the PCMH, formulated and endorsed in February 2007, are sound and describe the ideal toward which we aspire. However, there is an element running implicitly through these joint principles that is difficult to achieve yet indispensable to the success of the entire PCMH concept. The incorporation of behavioral health care has not always been included as practices transform to accommodate to the PCMH ideals. This is an alarming development because the PCMH will be incomplete and ineffective without the full incorporation of this element, and retrofitting will be much more difficult than prospectively integrating into the original design of the PCMH. Therefore we offer a complementary set of joint principles that recognizes the centrality of behavioral health care as part of the PCMH. This document follows the order and language of the original joint principles while emphasizing what needs to be addressed to insure incorporation of the essential behavioral elements. It is intended to supplement and not replace the original Joint Principles document, which still stands.

Getting mental health care where it is needed.

There has been a powerful call for better funding for mental health services in the United States. The effort to build capacity in mental health centers is much needed. We need more and better-trained staff, funding that can reduce barriers, and shorten waiting times. The movement to integrate mental health clinicians as part of the care team in primary care will be much more likely to find and engage people who are very troubled but are not seeking mental health care. To increase the likelihood of getting care to troubled people earlier and engaging them in care more effectively, any effort to improve funding for mental health should include a clear focus on improving the integration of mental health into primary care. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

A special issue on the patient-centered medical home.

This special issue on the Patient-Centered Medical Home (PCMH) reflects its times. At the present time, the PCMH is an aspirational model with a few pilots functioning well around the country. How long the current period of idealism, fueled by the energy of early adopters, the consensus of diverse stakeholders, and the dollars of the Affordable Care Act will continue is anybodys guess. Representing the thinking of some of the best minds in the field, the articles in this issue have an aspirational and idealistic tone as much as a descriptive and analytic one. A year ago the balance would have been tipped more toward idealism and model building and a year from now it would, in all likelihood, tip more toward model description and analysis. The authors in this volume have been personally responsible for helping to move behavioral health to a more central position in the PCMH model.

The development of joint principles: Integrating behavioral health care into the patient-Centered medical home

This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH.

Form(s) in the patient-centered medical home.

Care plans are becoming a focus of conversation and development in primary care as the patient-centered medical home is developing in the various states. In this issue, there are two accounts of attempts to develop and implement such generative processes through the use of a form. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

A vision for Families, Systems, & Health.

Producing a journal that regularly offers clear articulations from many domains of relationship in health and healthcare, and occasionally offers a new articulation of the patterns that connect across domains, is the first goal the new editorial team for Families, Systems, & Health has set itself. The second is making FSH an accepted and well-used outlet in the worlds of medicine, mental health, and systems thought. As an approach to both goals, the editorial team wants to broaden the readership and the contributors to FSH by making the journal accessible to authors who do their scholarly writing in Spanish. The plan is to be able to take a manuscript in Spanish from submission, through all the steps in the editing process, to an accepted final form before it is translated. (PsycINFO Database Record (c) 2009 APA, all rights reserved).