Integration of Mental Health Services in Primary Care Settings
People with substance use disorder (SUD) generally benefit from having access to an integrated system
of care. This model focuses on the
integration of mental health services, including substance use disorder services, into primary care
settings to increase access to and coordination of care for people with SUD. The Primary
Care Behavioral Health Model of the Rural Services Integration Toolkit provides more information
about this approach.
Possible approaches for integration include providing access to care for SUD in a primary care
setting using telehealth
and including mental health consultants on the primary care team. Other integrated care opportunities
for treating opioid use disorder can be found in Integrated
Models for Opioid Treatment Programs in an Era of Increasing Opioid Addiction, Health Reform, and
Parity. This paper describes several models including coordination with physicians prescribing
buprenorphine, and coordinating with primary care providers, psychiatric providers, and specialty
Examples of Integration with Mental Health and Primary Care
- Verde Valley Guidance Clinic in Cottonwood, Arizona provides primary care and treatment for SUD to women via
the A Woman's
World program. Services include individual and group therapy, healthcare services,
crisis intervention, and an on-site pharmacy.
- The Armstrong-Indiana-Clarion
Drug and Alcohol Commission's Addiction Recovery Mobile Outreach Team (ARMOT) in Shelocta,
Pennsylvania identifies individuals who are receiving care at emergency departments, psychiatric
units, or other healthcare facilities and are in need of SUD services. After hospital staff refer a
client to the ARMOT program, a mobile case manager provides assessments and referrals based on the
- The Southwest Montana
Community Health Center in Butte, Montana has integrated behavioral health services into its
pre-existing primary care setting in order to link patients with substance use disorders to
counseling and other community programs.
Considerations for Implementation
A major challenge in seeking mental health services, particularly in small communities, is the stigma
associated with mental health and SUD. The co-location of mental health and primary care services may
help to reduce this stigma because many different types of services are available in one setting.
The integration of mental health and primary care benefits people with SUD who may have co-occurring
conditions often linked with substance misuse, including lung disease, cardiovascular disease,
HIV/AIDS, hepatitis, depression, and anxiety. The integration of services allows people to receive a
variety of healthcare services.
When integrating SUD services with primary care services, additional considerations include necessary
trainings, reimbursement and billing changes, and liability and confidentiality issues. The Rural
Services Integration Toolkit provides additional information about these considerations.
Program Clearinghouse Examples
Resources to Learn More
in Addictions Treatment
Offers SUD providers information on integrating SUD services with primary care through the
perspectives of organizations that have experienced the integration in rural settings. Discusses the
events prior to integration, and the challenges and lessons learned. Includes a provider checklist to
help in the redesign supporting integration.
Organization(s): SAMHSA-HRSA Center for Integrated Health Solutions
Delivery Models for Opioid Treatment Programs in an Era of Increasing Opioid Addiction, Health
Reform, and Parity
Discusses opioid addiction treatment programs (OTPs) as comprehensive treatment hubs providing new
treatment options, including MAT, and integrated service delivery in primary care and behavioral
health settings. Recommends effective service delivery models of OTPs as a means of improving the
care offered to patients.
Author(s): Stoller, K, Stephens, M, & Schorr, A.
Organization(s): American Association for the Treatment of Opioid Dependence
in Health: Mental Health, Primary Care and Substance Use Interagency Collaboration Tool Kit
A guide to assist in the development of an integrated primary care and behavioral health services
program. Covers team building, information sharing, finances, medication coordination, interagency
agreements, evaluation, and the client's perspective.
Organization(s): Integrated Behavioral Health Project