No abstract

Introduction Residents of the Rio Grande Valley (RGV), Texas have among the worst health outcomes nationally. Rates of chronic disease such as obesity, diabetes, and related mortality in the RGV exceed those in most other regions of Texas and the nation [1, 2]. Poverty is pervasive, placing residents at high risk for poor health; they are more likely to be exposed to environmental hazards and have higher rates of chronic physical and mental health concerns [3-5]. At its foundation, integrated behavioral health care (IBH) aims to address multiple health concerns, and related social determinants, by bringing behavioral health and primary care services together. No single model of IBH can be applied universally to health or social service settings; however, each approach is team-based and involves collaboration between multidisciplinary health and social service providers to achieve shared patient and community outcomes [6]. The SAMSHA-HRSA Center for Integrated Health Solutions categorizes these approaches into three levels: coordinated, focused on communication between providers; co-located, models bringing different services into the same physical space; and integrated, which involves practice and workflow changes [7]. A 2016 update on research on integration of behavioral health and primary care emphasized the increasing strength of evidence highlighting the success of these approaches [8]. IBH has been effective in various populations [9-12] with some studies focusing on specialty populations such as adolescents and those with substance use disorders or severe mental illness, which may need tailored and focused integrated care [13-15].