The Primary Care Behavioral Health Model

The Primary Care Behavioral Health (PCBH) model is a team-based primary care approach to managing behavioral health problems and biopsychosocially-influenced health conditions. The model’s main goal is to enhance the primary care team’s ability to manage and treat such problems/conditions, with resulting improvements in primary care services for the entire clinic population. The model incorporates into the primary care team a behavioral health consultant (BHC), sometimes referred to as a behavioral health clinician, to extend and support the primary care provider (PCP) and team. The BHC works as a generalist and an educator who provides high volume services that are accessible, team-based, and a routine part of primary care.

Behavioral Health Consultant/Clinician’s Role

Features of the Behavioral Health Consultant’s role can be summarized using the acronym GATHER: Generalist, Accessible, Team-based, High volume, Educator, and Routine.

Accessible

BHC strives for on-demand accessibility for patients and care team.

Team-based

BHC shares clinic space/resources and assists the team in various ways.

High Volume

BHC aims for high patient volume to support population health management.

Educator

BHC teaches behavior change and resilience strategies to the team.

Routine

BHC operates as a regular part of healthcare.

To accomplish these goals, BHCs use focused (typically 15-30 minute) visits to assist with specific symptoms or functional improvement. Follow-up is based in a consultant approach in which patients are followed by the BHC and PCP until functioning or symptoms begin improving; at that point, the PCP resumes sole oversight of care but re-engages the BHC at any time, as needed. Patients not improving are referred to specialty care, though if that is not possible, the BHC may continue to assist until improvements are noted. This consultant approach also aims to improve the primary care team’s biopsychosocial management of health conditions in general with the goal of better care for the whole clinic population.