The Philadelphia Primary Care Behavioral Health Network

Integrating Care, Practice, Workforce and Advocacy

Abstract

At the simplest level, integrated behavioral and physical health care occurs when behavioral health and primary care providers work together to address the physical and mental health needs of their patients (Agency for Healthcare Research and Quality, 2008). This level of collaboration, however, demands the development of a certain skill set, which is uncommon and not taught (Gawande, 2011). In contrast to a collaborative style of practice, for centuries the practice of Western medicine has favored mind-body dualism over unity, resulting in the silo-ing of physical and mental health care. Nevertheless, in the United States, most individuals view primary care as their first stop for physical health and mental health concerns, so much so that primary care has been referred to as the “de facto mental health system” (Kessler, & Stafford, 2008). Primary care as the first stop makes sense; many medical problems are accompanied by psychological distress, and many psychological problems present with medical symptoms. Despite this, during their training, most primary care providers are only minimally exposed to caring for psychiatric conditions, and most mental health professionals are trained as specialists working outside of the medical care system. Neither profession receives adequate training in working as a team and collaboratively managing care.