Current strategies and barriers in integrated health care: a survey of publicly funded providers in Texas

Abstract 

Objective

This study aimed to assess the extent to which publicly funded behavioral health and primary care providers in Texas have integrated physical and mental health care, the strategies used in implementation efforts and barriers encountered in integration.

Method

A survey of behavioral health and primary care providers in Texas was conducted to examine providers' perceptions of efforts to integrate physical and mental health care in their organizations. Integration strategies utilized, health conditions targeted and barriers to implementation were evaluated. Descriptive analyses were conducted to determine organizations' current integration strategies and perceived clinical, organizational and financial barriers to integration.

Results

Out of 382 surveys initially distributed, a final subsample of 84 organizations with complete data was examined, a response rate of 22%. Among this sample of behavioral health and primary care providers, many shared integration practice strategies and endorsed similar barriers to integration.

Conclusion

The findings from this study suggest that publicly funded organizations in Texas attempting to integrate physical and mental health care were aware of and employing practice strategies considered essential to the successful treatment of mental health issues in primary care settings. Attention to barriers that still exist, especially regarding workforce and funding issues, will be critical for organizations considering and attempting integration.

Keywords: Integrated health care, Collaborative care, Primary care, Physical and mental health services