Integrating Behavioral Health and Primary Care in Two New Jersey Federally Qualified Health Centers.

This column describes a unique model for integrating behavioral health services into two New Jersey federally qualified health centers (FQHCs). The pilot project, funded by a private foundation grant, offers a lens for exploring the distinct challenges and opportunities faced by FQHCs serving diverse populations. The behavioral health services provided through this project were comprehensive, including behavioral health care, chronic disease management, and computerized cognitive-behavioral therapy. Although many changes to health center structure and staffing were required, building on existing infrastructure allowed substantial progress toward implementation of an integrated (and eventually self-sustaining) care system in one year. The challenges facing FQHCs wishing to integrate behavioral health services into their routine operation will vary; this project can provide a blueprint by which comprehensive behavioral health care can be integrated into existing medical clinic services.

A Technical Assistance Framework to Facilitate the Delivery of Integrated Behavioral Health Services in Federally Qualified Health Centers (FQHCs).

An implementation approach, featuring direct, onsite technical assistance is described, and findings from a pilot study assessing the capability of Federally Qualified Health Centers to provide integrated behavioral health services are presented. Investigators used the Behavioral Health Integration in Medical Care (BHIMC) index to measure integration at baseline and follow-up at four FQHCs in New Jersey. Results indicate that the average baseline capability score of 1.95 increased to 2.44 at follow-up, almost one-half point on the five-point BHIMC index. This pilot project demonstrates that co-occurring capability can be assessed, and system-wide technical assistance can be delivered to assist FQHCs in integrating behavioral health services. Future research should test technical assistance as an implementation strategy to promote the integration of medical care and behavioral health treatment on a wider scale.