Integrated Behavioral Health Service Models and Core Competencies

Abstract

Health care in the United States continues to remain fragmented, inefficient, inequitable, and ineffective. These factors, combined with long histories of inequities in access to social determinants of health and wealth, have contributed to health disparities for individuals who identify as Black, Indigenous and People of Color (BIPOC), disparities that have been exposed by the COVID-19 pandemic. Integrating health and behavioral health services can address system fragmentation and inequitable access to resources. In this chapter, I define integrated behavioral health practice (IBHP) and provide an overview of the various factors that have led to the rise of integrated behavioral health care (IBHC) in the United States over the last two decades. These inter-related and overlapping factors include service fragmentation, health disparities, the realization of the role of trauma in health outcomes, and the recognition of the co-occurring and bidirectional nature of mental illnesses, addiction, trauma, and physical illnesses. I also identify the barriers to full integration of behavioral health care in health settings and explore potential solutions by highlighting specific models of integrated behavioral health care and the competencies associated with effective integrated behavioral health practice.