A significant treatment gap exists for individuals living with mental health and substance use conditions. As of 2023, 55% of adults who experience some form of mental illness receive no treatment and 60% of youth with major depression go without help. Currently, and for the foreseeable future, the United States is experiencing a shortage of behavioral health providers to deliver needed services. One of the most effective ways to close the prevention and treatment gap in the mental health and substance use fields is through behavioral health integration (BHI). For the purposes of this report, the term BHI refers to the integration of mental health and substance use services into primary care settings in a manner that is agnostic to model and service design. High quality, integrated primary care services provide continuous, person-centered behavioral health care that considers the needs and preferences of individuals. Vital to increasing the reach of integrated care models is a health care workforce that is adequately trained and supported in BHI delivery. Several evidence-based models - including the Collaborative Care Model (CoCM) and the Primary Care Behavioral Health Model - integrate behavioral health into primary care and are reimbursed by Medicare, some state Medicaid plans, and commercial payers. Over the past year, the Bipartisan Policy Center undertook an extensive effort to develop evidence-based, federal policy recommendations to support and grow the workforce responsible for delivering integrated behavioral health and primary care services. BPC conducted a series of interviews and hosted two private roundtables with health care policy and workforce experts, providers, payers, and patient advocates to gain insight into the opportunities and barriers related to the integrated care workforce. BPC’s March 2021 Behavioral Health Integration Task Force report looked broadly at ways to achieve the integration of behavioral health and primary care. This report builds on those recommendations by focusing on ways to train, recruit, pay for, and flex the BHI workforce. Although our recommendations focus on Medicare and Medicaid beneficiaries, the workforce investments outlined here have broad implications for the entire health care delivery system.
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1 online resource (1 PDF file (42 pages)) : illustrations