The Evolution of Behavioral Primary Care.

Abstract

The financing, organization, and delivery of behavioral health care services has undergone dramatic change in the past 25 to 30 years. The authors trace the evolution of behavioral health care delivery in the United States over the past several decades and find (a) that the value of mental health "carve-outs" has diminished greatly and that they are being replaced by "carve-ins," (b) that primary care physicians (PCPs) are becoming a primary source of mental health care secondary to the introduction of new medications, and (c) that PCP treatment of mental health disorders is suboptimal. The authors conclude that the behavioral health care system is entering an era of flux as it experiments with ways of integrating behavioral and primary care. Opportunities for psychologists are explored.

Article Commentary: Integral Healthcare: The Benefits and Challenges of Integrating Complementary and Alternative Medicine with a Conventional Healthcare Practice

“…Of great concern are the growing number of uninsured persons and the lack of reasonable mental, emotional and spiritual healthcare coverage worldwide. 5 The way insurance is relegated is perhaps one of the biggest underlying deterrents in using the integral healthcare model. Conceivably the answer lies in moving from a carve-out system to a carve-in structure of managed behavioral healthcare.…”

Clinical Geropsychology and Primary Care: Progress and Prospects.

“…Successful practice of primary‐care geropsychology will require the development of skill sets that are outside of the typical range of clinical psychology training. At a minimum, psychologists must have expertise in geropsychology issues, the primary‐care context, and increasingly in the business management aspects of practice (e.g., see Gray et al, 2005). A number of articles and chapters have outlined training needs for psychologists in primary care, at the predoctoral, internship, and postdoctoral level (Dobmeyer, Rowan, Etherage, & Wilson, 2003; McDaniel, Belar, Schroeder, Hargrove, & Freeman, 2002), and more specialized training issues related to primary care and geropsychology (Haley, 2004; Molinari et al, 2005; Quails et al, 2002).…”

Clinical Geropsychology and Primary Care: Progress and Prospects

“…Successful practice of primary-care geropsychology will require the development of skill sets that are outside of the typical range of clinical psychology training. At a minimum, psychologists must have expertise in geropsychology issues, the primary-care context, and increasingly in the business management aspects of practice (e.g., see Gray et al, 2005). A number of articles and chapters have outlined training needs for psychologists in primary care, at the predoctoral, internship, and postdoctoral level (Dobmeyer, Rowan, Etherage, & Wilson, 2003;McDaniel, Belar, Schroeder, Hargrove, & Freeman, 2002), and more specialized training issues related to primary care and geropsychology (Haley, 2004;Molinari et al, 2005;Qualls et al, 2002).…”