Perceptions of Mental Health and Substance Use Disorder Services Integration Among the Workforce in Primary Care Settings

Abstract

It is important to understand the perceptions of staff members who will be implementing the expected integration of mental health and substance use services into primary care. Surveys were administered to mental health/substance use disorder (MH/SUD) staff, support staff (SS), and primary care providers (PCPs) from three organizations (seven sites) that were participating in an initiative to promote the integration of MH/SUD services into primary care in Kern County, California. Results suggest that integration and MH/SUD services are highly valued among all staff types, and that staff are uniformly interested in further MH/SUD training. However, there were significant differences in staff perceptions. MH/SUD staff and services were valued by PCPs more than MH/SUD staff perceived being valued by PCPs, and MH/SUD staff were less likely to agree that communication with PCPs was good. Information seemed to flow better from MH/SUD staff to PCPs than in the other direction.

An Examination of Perceptions in Integrated Care Practice

“…The supporting staff expressed high levels of comfort being the first-line response for people with mental health disorders, substance use disorders, and/or psychosocial issues. This perception is consistent with previous supporting staff survey (Urada et al 2012) where they rated their own comfort as being first-line responder of mental health and substance use issues very highly. These supporting staff expressed their satisfaction with access to behavioral health staff and perceived highly, that the integrated behavioral health model increases ease of access to behavioral health services for patients.…”

“…In addition, the PCPs agreed that the co-located mental health provider frequently clarified diagnosis and recommended treatment plan for referred patients. These findings are an improvement from the findings of one integrated care satisfaction PCP/mental health provider survey (Urada et al 2012) that noted poor communication between the PCP and mental health provider attributable to the tendency for the PCP to ask the mental health provider for information but not provide information to the mental health provider.…”

“…The support staff and patient surveys were adapted from questionnaires developed by the Tides Center's Integrated Behavioral Health Project, and modified by (Urada et al 2012). The support staff and patient questionnaires were further modified to include demographics items.…”

“…Successful implementation of integration of primary health services in behavioral health settings or vice versa depends on the integrated efforts of various types of staff, such as mental health/substance use disorder staff, support staff, and primary care providers (Urada et al 2012). Patients’ perceptions and level of satisfaction also, is a key factor in the successful implementation of integration.…”

Integration of substance use disorder services with primary care: health center surveys and qualitative interviews

“…The organization’s survey responses were similar to those of the FQHCs. More information on this project can be found elsewhere [26]. Our priority was to find at least some organizations that were involved in integration efforts so we intentionally targeted counties that were known to be pursuing integration in some of their FQHCs based on presentations at UCLA’s statewide Integration Learning Collaborative a and informal discussions with representatives from the County Alcohol and Drug Program Administrators Association of California.…”