With up to 70% of primary care visits prompted by psychosocial concerns, busy primary care clinics are increasingly addressing complex behavioral health (BH) needs. Substantial evidence demonstrates that the integration of BH into primary care improves access and outcomes, yet clinics face significant challenges in real-world implementation. This collaborative care integration project used psychiatric mental health nurse practitioner faculty as integration and BH specialists at an urban primary care clinic serving a diverse and largely indigent population. The project weathered leadership changes, information system shortcomings, and a shift to telehealth during coronavirus disease 2019. The initial outcomes include increased levels of integration and improved depression and diabetes metrics.

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