The purpose of this project was to understand which behavioral health services primary care physicians currently provide for their clients and how often they do so.
A large percentage of patients experiencing behavioral health issues seek help in emergency rooms and in primary care settings. Most are discharged without receiving behavioral health treatments. Furthermore, roughly half of all care for common psychiatric disorders is provided in primary care settings, and patients are often more open to discussing mental health concerns with their primary care physicians. With an increasing demand for behavioral health care, integration of primary care and behavioral health may be a promising method to increase patient access to quality behavioral health care.
Research has largely focused on the benefits of integration and how to facilitate it, rather than on physicians’ experience with providing behavioral care to patients. This project’s primary directive was to understand the level of preparedness of primary care providers to handle the behavioral health needs of their patients.
Of the 313 physicians that participated in the survey, 26% practiced primarily in a rural area and 74% practiced in a non-rural area. Rural physicians showed higher rates of diagnosis and treatment of patients with anxiety disorders, ADHD, bipolar disorder, clinical depression, SMI, and SUD than physicians practicing in non-rural areas, a finding attributable to higher rates of rural behavioral health treatment being provided in primary care.
Overall, respondents were more likely to screen, diagnose, and treat patients with clinical depression, anxiety disorders, and substance use disorder (SUD) than attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, and serious mental illness (SMI). Higher rates of screening, diagnosing, and treating patients with behavioral health disorders correlated with physicians’ self-reported confidence in treating behavioral disorders.
These findings are incredibly useful for understanding the behavioral health competencies that primary care physicians need further training in to be truly prepared for a future in integrated practice.