Project 3.a.i – Integration of Primary Care and Behavioral Health Services

Why FLPPS Chose this Project

The FLPPS region typically separates physical and behavioral healthcare into two separate non-integrated systems.  However the need to integrate these networks is especially critical because of the higher than average prevalence of behavioral health conditions in our region.


7% of all ED admissions have a behavioral health primary diagnosis,
the highest of all disease states.


There currently is a clear lack of integration between the two systems which has led to poor outcomes for those seeking care in both primary care and behavioral health settings. Not only do these individuals’ behavioral health conditions influence their mental health, but these conditions have real consequences for their physical health as well. Establishing connections between the behavioral and physical healthcare systems may ensure that Medicaid patients are seen in the appropriate setting and receive the most appropriate care for their conditions.


17% of all hospital readmissions are associated with an individual
having a behavioral health diagnosis.


Not only do behavioral health conditions represent resource intensive needs on their own but for individuals who have both behavioral and physical health conditions, the interplay of the multiple conditions can exponentially increase the healthcare needs of a particular patient.


77% of inpatient mental health or substance abuse admissions
have a co-occurring medical diagnosis.


This lack of integration is exacerbated by a shortage of licensed behavioral health professionals, and the lack of cultural and behavioral health competence among physical health professionals to appropriately diagnose and manage behavioral health disorders.


12 of 13 FLPPS counties received a designation as mental health Healthcare Professional Shortage Area (HPSA).  Further, few behavioral health providers are multi-cultural and/or multi-lingual. 


What Success Looks Like

Integrated services that:

  1. identify behavioral health diagnoses early, allowing rapid treatment,
  2. ensure treatments for medical and behavioral health conditions are compatible and do not cause adverse effects, and
  3. de-stigmatize treatment for behavioral health diagnoses. 

Integration of mental health and substance abuse with primary care services to ensure coordination of care for these services. The goal of this project is to have care for all conditions delivered under one roof by a known healthcare provider.

Additional Resources

  • NYS DOH Shared Space Guidance regarding co-location of primary care and behavioral health services
  • NYS DOH, in collaboration with The National Council for Behavioral Health and Office of Mental Health (OMH), has developed the following guidance document to address common questions about the use and administration of the Patient Health Questionnaires 2 and 9 (PHQ 2 and 9) as a preventive depression screening tool in the integrated care setting. 
  • National Council for Behavioral Health Educational Video Series on Integrated Care: