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Abstract

Objective

This article describes the characteristics and early implementation experiences of community behavioral health agencies that received Primary and Behavioral Health Care Integration (PBHCI) grants from the Substance Abuse and Mental Health Services Administration to integrate primary care into programs for adults with serious mental illness.

Methods

Data were collected from 56 programs, across 26 states, that received PBHCI grants in 2009 (N=13) or 2010 (N=43). The authors systematically extracted quantitative and qualitative information about program characteristics from grantee proposals and semistructured telephone interviews with core program staff. Quarterly reports submitted by grantees were coded to identify barriers to implementing integrated care.

Results

Grantees shared core features required by the grant but varied widely in terms of characteristics of the organization, such as size and location, and in the way services were integrated, such as through partnerships with a primary care agency. Barriers to program implementation at start-up included difficulty recruiting and retaining qualified staff and issues related to data collection and use of electronic health records, licensing and approvals, and physical space. By the end of the first year, some problems, such as space issues, were largely resolved, but other issues, including problems with staffing and data collection, remained. New challenges, such as patient recruitment, had emerged.

Conclusions

Early implementation experiences of PBHCI grantees may inform other programs that seek to integrate primary care into behavioral health settings as part of new, large-scale government initiatives, such as specialty mental health homes.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: The Artists' Parents in the Store, by Sidney Goodman, 1973–1975. Oil on canvas, 58½ × 77 inches. Collection of the Butler Institute of American Art, Youngstown, Ohio.

Psychiatric Services
Pages: 660 - 665
PubMed: 23584674

History

Published in print: July 2013
Published online: 15 October 2014

Authors

Details

Deborah M. Scharf, Ph.D.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
Nicole K. Eberhart, Ph.D.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
Nicole Schmidt, M.A.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
Christine A. Vaughan, Ph.D.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
Trina Dutta, M.P.P., M.P.H.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
Harold Alan Pincus, M.D.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.
M. Audrey Burnam, Ph.D.
Dr. Scharf is affiliated with the Department of Behavioral Health Sciences, RAND Corporation, 4570 Fifth Ave., Suite 600, Pittsburgh, PA 15213 (e-mail: [email protected]). Dr. Eberhart, Ms. Schmidt, Dr. Vaughan, and Dr. Burnam are with the Department of Behavioral Health Sciences, RAND Corporation, Santa Monica, California. Ms. Dutta is with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Pincus is with the Department of Psychiatry, Columbia University, New York City.

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