Advancing Integrated Behavioral Health Care In Texas And Maine: Lessons From The Field

“We don’t even speak the same language,” a primary care provider explained during an Integrated Behavioral Health/Primary Care team meeting. “So, it’s not surprising it took us a lot longer to learn how to work together than we anticipated.” A substantial lesson for those working to integrate care is the complexity of it and the time needed to deal with the professional cultural differences encountered when primary care and behavioral health providers begin working together.

Foundations from two states offer this lesson and other tips they learned while engaged in transforming health care systems to provide integrated care since 2006. Because the transformation to deliver integrated care is systemic, these lessons are layered to reflect different levels of change: policy-level changes, organizational changes, and clinical practice changes.

In 2006, foundations in Texas and Maine began supporting integrated behavioral health and primary care by convening of stakeholders, strategic planning, implementation of service delivery initiatives, grant making, policy work, and learning communities. (Such communities bring cross-site organizations together to build capacity and expertise in integrated care through shared learning opportunities.)

The Hogg Foundation for Mental Health funded integrated care through a three-year grant program to bring the Collaborative Care model to clinics in Texas. It also funded a comprehensive integrated care resource guide, statewide learning communities, and a statewide conference. It partnered with the US Department of Health and Human Services (HHS) Office of Minority Health to generate two major reports (a consensus report and a funders’ report) and a comprehensive literature review—all exploring integrated care as a strategy to eliminate health disparities.