The majority of primary care clinicians say they want to provide more behavioral health care but need additional training tools and resources.
This comes as more providers and payers emphasize the benefits of primary and behavioral health care integration.
Nearly 40% of primary care providers (PCPs) are screening patients for behavioral health conditions, according to a new report from The Advisory Board, which included survey responses from 300 PCPs.
While the bulk of providers surveyed said the increase in screening is due to more patients presenting behavioral health concerns, only 20% of clinicians are incentivized for behavioral health screenings. Authors of the report note that when a provider is incentivized or reimbursed for the screenings, they are more likely to incorporate them into their practice.
Primary care is often the first stop for patients looking for behavioral health care. About 90% of patients with low-acuity behavioral health concerns said they are likely to seek care from their PCP, according to the Advisory Board report.
Some health organizations have already put in support to help PCPs address behavioral health concerns.
“So often, by the time someone is saying to themselves, ‘I really should get some help,’ or someone in their life is saying, ‘you need some help,’ [the problem has] been going on for quite some time,” Lewis Zeidner, M Health Fairview’s system director for clinical triage and transition services, previously told Behavioral Health Business. “Many people see their primary care provider regularly, and if challenges were intervened earlier, oftentimes, they could get access quicker.”
M Health Fairview is a partnership between the University of Minnesota, University of Minnesota Physicians and Fairview Health Services. The health system includes 10 hospitals and 60 clinics.
M Health Fairview addresses the increasing need for behavioral health services by co-locating master’s and doctorate-level mental health clinicians at primary care offices.
While 87% of PCPs say that embedded staff, like M Health Fairview’s model, is effective, only 25% say it is available to them.
Other resources like referral guidance, medication prescribing resources and on-demand expertise are more popular but are still not the norm.
PCPs want more training
There is still a long way to go regarding PCP training. Half of PCPs surveyed said they receive 1 to 10 hours of ongoing behavioral health training annually, and 16% said they don’t receive any ongoing behavioral health training, according to The Advisory Board. The organization’s report found that more hours of training directly correlated with greater confidence in treating behavioral health conditions.
Still, many patients are getting their behavioral health prescriptions from their PCP. The report found that 37% of providers surveyed don’t feel confident prescribing medications to treat behavioral health conditions, but 85% of those PCPs are prescribing the medicines anyway.
But many providers are open to more training. About 66% of providers said they wanted more behavioral health medication training, according to the report.
Some health systems have begun implementing training programs for clinicians working in the primary care setting to address behavioral health concerns. For example, Geisinger won a $2.8 million grant from the U.S. Health Resource and Service Administration to develop fellowship programs that train advanced practitioners to provide SUD care in a primary care setting.
Part of that training will be helping to educate prescribers about medication-assisted treatment (MAT). Late last year, the X-waiver, which required prescribers to have additional certifications to prescribe MAT for people with opioid use disorder (OUD) was eliminated.
“We just keep giving more and more education and being there to hold hands and say, ‘We can do this together,’” Tracy Rockefeller, a nurse practitioner specializing in addiction medicine at Geisinger, previously told BHB. “And if you’re uncomfortable, we can do it for you, so that we make sure that patients have access.”
Danville, Pennsylvania-based Geisinger includes 10 hospital campuses, a health plan and a research institute.