Creating a Future-Proof Practice with Integrated Behavioral Health Services

April 26, 2024

The demand for behavioral health care isn’t just growing, it’s becoming more complex. In the annual Practitioner Pulse Survey, the American Psychological Association (APA) reports that many patients need additional care and present more severe symptoms than in previous years. Practitioners are also treating increasingly diverse patients – in terms of health, age, sexual and gender identification, and racial and ethnic backgrounds.

No wonder the AMA survey respondents also report regularly participating in care teams. In today’s complex care landscape, delivering integrated behavioral health services makes a lot of sense. 

Offering multidisciplinary services can take different forms – from a single practitioner obtaining new certifications to many practitioners forming a referral network to building an integrative clinic with all modalities under one roof. Regardless of format, the goal is to give each patient the most efficient access to a personalized mix of care that promotes healing. 

In this post, we’ll explore the benefits of integrated behavioral health and a few common challenges associated with working in this model. We’ll also examine how having the right practice management software can smooth collaboration and set your practice up for long-term success. 

The significance of integrated behavioral health

Integrative behavioral health is an approach to care that focuses on the whole individual and considers different factors contributing to mental wellness, including biological, psychological, and social. 

It’s not a new idea. In 1977, psychiatrist George Engel championed a holistic approach to care based on a biopsychosocial model that considered multiple dimensions of illness. The approach is sound when you consider the impact of mental wellbeing on overall health. 

According to the Centers for Disease Control (CDC), mental and physical health are equally important components of overall health. For example, the CDC reports that “depression increases the risk for many types of physical health problems, particularly long-lasting conditions like diabetes, heart disease, and stroke.” Conversely, chronic health conditions can also increase the risk of mental illness. 

When you layer on additional trends, behavioral health integration makes even more sense: 

  • Behavioral health issues cost society as a whole. The estimated direct and indirect costs of behavioral illness total up to 4% of global Gross Domestic Product (GDP) – that’s higher than the combined burden of cancer, diabetes, and respiratory disease.
  • A shortage of skilled providers. Even in high-income countries, the shortage of mental health specialists is persistent. For example, more than 100 million people in the United States live in communities designated as behavioral health professional shortage areas. 
    • Researchers are championing a task-sharing approach as a promising strategy for dealing with the practitioner shortage. Distributing service delivery across a range of qualified professionals is one way to scale availability.  
  • The shift to preventative care. Preventive care and population health management seek to improve outcomes and reduce costs. Integrated behavioral health services play a crucial role in preventive care by addressing risk factors like stress, addiction, and lifestyle factors.
    • Take nutritional psychiatry, for example. We know the mind-gut connection is strong, and research shows that nutritional interventions can have psychoprotective potential. Nutritional psychiatry investigates how specific nutrients, dietary choices, and physical states affect brain function, mood, and behavior. 
    • Coaching around health and nutrition offers a unique perspective to guide behavioral change and improve physical and mental wellbeing. 
Diagram from an article published in Frontiers of Nutrition showing the relationship between nutrition and mental health. 
Image source article: A review of current knowledge about the impact of diet on mental health
  • Value-based care and payment models. Value-based care models incentivize healthcare providers to deliver high-quality, cost-effective care that holistically improves patient outcomes.
    • Integrated behavioral health services are well aligned with this model because they address the underlying factors contributing to health issues and reduce the need for unnecessary medical interventions – and insurance claims. 
  • Patient expectations for holistic care.  Social sharing platforms, like TikTok and Instagram, are democratizing access to health and wellness information. Patients are leaning in; almost 1 in 5 Americans will consult TikTok before their doctor for health advice. The top three conditions Americans are most likely to turn to health influencers for advice on are anxiety, weight loss, and depression.
    • This level of access to health and wellness information can be problematic – notably, if the person disseminating the advice lacks the proper credentials. However, it drives many patients to advocate for and expect a more holistic approach to their care. Practitioners who meet these patients where they are can boost engagement. 

Challenges in integrating behavioral health

review of 79 trials of collaborative care found the integrated behavioral health care model significantly improved outcomes for patients with depression and anxiety. 

Integrated care can also boost practice sustainability, simplifying healthcare delivery and decreasing administrative burden. 

With all these positive indicators, why aren’t more practitioners implementing an integrative approach? Let’s take a peek at some top challenges associated with this care model. 

  • Stigma. Nobody questions a person’s actions when seeking help to mend a broken arm or lower high blood pressure. Yet, there’s still a stigma attached to behavioral and mental health. Stigma makes some patients less likely to seek help. And those who do pursue treatment may be less willing to share personal details, even with clinicians. With several clinicians operating as a multidisciplinary team, getting patients to open up may be even more challenging. 
  • Care fragmentation. Practitioners need more resources for managing and coordinating behavioral health services. For example, how does a practitioner get plugged into a vetted network of referral partners? Talent shortages, financial constraints, and technology gaps will exacerbate the fragmentation problem. 
  • Siloed technology. Seamless behavioral health integration also requires flawless technology integration. Coordination and communication are critical success factors for this care model. Integration requires data to be openly yet securely shared between members of the integrated care team to provide a holistic view and personalized approach for every patient. 

Role of practice management software in integrated behavioral health

If the future of mental health care is integrative, then practitioners choosing this model need the right technology to meet that future with open arms. All-in-one mental health practice management software fits the bill. 

Comprehensive Patient Profiles

Accurately capturing and managing behavioral health history is critical when delivering integrated behavioral health services. A practice management solution provides tools to ease the complexity. 

  • Intake forms can help you get up to speed on behavioral health history basics before your first session. You can also incorporate must-haves like waivers, insurance billing details, and payment preferences into the intake process. 

Ideally, you’ll have the flexibility to build your forms, upload the ones you already use, or tap into pre-built templates. For example, Practice Better has built-in mental form templates, including General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire 9 (PHQ 9), and the PTSD Checklist for DSM-5 (PCL 5).

  • The ability to automate form sends is also a huge time-saver – like right after booking or regularly. 
  • Built-in note templates also include predefined sections to capture different aspects of a patient’s history, so organizing and accessing information is a snap. Bonus: when your notes are clear and organized, they’re easier to share with other care providers in your care team.

Collaborative care coordination

What are the goals of integrated behavioral health care? One important goal is to boost positive outcomes by bringing together the unique expertise of diverse physical and behavioral health practitioners. 

  • This makes integrated care more prone to communication gaps, which can erode the efficacy and safety of care. 
  • These gaps can also put you at risk for litigation. An investigation of 23,000 medical malpractice lawsuits found more than 7,000 of them could be attributed to communication failures. 
    • The collaboration features built into practice management software keep the lines of communication open. 
  • You can securely share services, forms, files, messages, and other resources. This way, everyone has what they need to succeed and be right in their workflow. 
  • You’ll want to ensure that sharing doesn’t expose protected health information (PHI). This will keep you HIPAA (Health Insurance Portability and Accountability Act) compliant
    • For example, Practice Better’s Teams plan lets you add employees, contractors, and administrators and then manage each person’s access and permission to keep your workspace secure.

Telehealth integration

Offering behavioral health services through telehealth can provide more patients with barrier-free access to counseling, behavioral interventions, and other types of support. 

According to the Agency for Healthcare Research and Quality, “While the evidence for using telehealth for the integration of behavioral and physical health is limited, there is a strong evidence base supporting the effectiveness of telehealth for:

  • Remote patient monitoring, communication, and counseling for patients with chronic conditions.
  • Psychotherapy as part of behavioral health treatment.
  • Psychiatry in acute care.
  • Consultations as part of outpatient, inpatient, and emergency care.

Integrated behavioral health teams can also use the telehealth functionality to collaborate and coordinate care plans. Technology makes it easier to build an integrative team without requiring every member to physically be in the same building. 

Treatment planning and goal setting

A mental health treatment plan provides a detailed roadmap for addressing a particular client’s behavioral health challenges. A measurement-based care (MBC) approach offers additional structure through standardized tools that drive more informed decision-making. 

Treatment planning in integrated behavioral health care lets patients benefit from multiple expert perspectives. For example, each member of an integrated behavioral health services team treating a client for depression and alcohol dependence would contribute interventions and set goals for physical and mental recovery: 

Intervention: Cognitive behavioral therapy (CBT) with a licensed mental health counselor to address depression and dependency. 

Goal: Develop coping skills, manage negative thoughts and emotions, and improve self-awareness. 

Intervention: Prescription medication.

Goal: Manage depressive symptoms through pharmacology. 

Intervention: Personalized nutritional support from a registered dietitian. 

Goal: Optimize brain function, stabilize mood, and support detoxification. Interventions might include reducing sugar and processed foods and addressing nutrient deficiencies through high-quality supplementation.

Intervention: Physical activity and mindfulness, including daily walks, meditation, and yoga, prescribed by a mindful movement practitioner. 

Goal: Improve mood and promote emotional regulation. Bonus: Practice Better offers features to simplify tracking goals, like journaling, check-in forms, and even integrations with lifestyle trackers

Selecting the right practice management software

Look at some essential software features for successfully practicing integrated behavioral health. 

  • Seek seamless integration with electronic health records (EHR) and other relevant platforms to support smooth workflows. Our behavioral health integration team’s example in the section above speaks to providing both CBT and nutrition counseling. 

Practice Better is fully integrated with That Clean Life. This technology consolidation makes providing nutrition guidance and other interventions simple for a more holistic view of patient treatment and behaviors.   

A screenshot from Practice Better demonstrating how to add a nutrition plan to a client protocol.
  • A unified calendar view is also handy if you work in a clinic with multiple practitioners. Similarly, managed billing allows you to choose how payments are processed – for example, using the team owner’s linked payment processor. 
  • Collaborative care tools keep all practitioners informed and aligned around a shared patient’s treatment. Look for features like secure messaging, shared care plans, and task assignment functionality.
  • Open communication with patients prevents roadblocks and promotes meaningful progress. Your practice management software should have built-in tools and educational resources that empower patients to actively participate in their treatment plans:
    • Look for a built-in patient portal that keeps everything organized in one place. 
    • Create educational libraries to supplement treatment with self-serve content.
    • Communicate between sessions with secure messaging. Send messages and reminders in real-time or schedule automatic delivery based on dates and triggers (for example, an SMS reminder two days before an appointment can help prevent no-shows). 
A screenshot of the Practice Better interface showing how to schedule a session reminder to be sent by SMS and email.
  • Opt for software that allows customizations to better accommodate the unique workflows and treatment modalities of your integrated behavioral health services care team. 

Look for features that support the creation of personalized treatment plans, customizable templates for different therapies, and documentation tailored to practitioner preferences.

  • As always, any platform you’re considering should meet HIPAA security standards if you’re operating in the United States. 

Note that Practice Better is also compliant with PIPEDA (Personal Information Protection and Electronic Documents Act), PHIPA (Personal Health Information Protection Act), and GDPR (General Data Protection Regulation). 

  • Remember the need for scalability to keep up with changes in your business model. Practice Better offers easy upgrading between plan levels so your platform can always meet your needs. 
  • Having built-in tools for creating programs also provides flexibility to expand your expertise beyond 1:1 sessions, making expert care more accessible. Bonus: programs are also fantastic for generating passive income

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A real-world example of behavioral health care

Alyson Roux

Alyson Roux is a Certified Nutrition Specialist®, Licensed Nutritionist, and Certified Intuitive Eating Counselor. She believes gentle meal planning and intuitive eating can help clients recover from eating disorders. 

By choosing a collaborative approach and using evidence-based counseling techniques, Alyson and her Nutrition Hive team deliver personalized support that allows clients to progress to intuitive eating. Alyson uses the many features built into That Clean Life that allow her to search, filter, customize, and share recipes with clients.  

“Having really simple and clear steps, and the notes about replacing ingredients is so helpful.

The ability to edit a recipe of add more notes if I know a client doesn’t like a certain ingredient helps make the food feel safer”

– Alyson Roux, Certified Nutrition Specialist, Licensed Nutritionist, and Certified Intuitive Eating Counselor

Future trends in integrated behavioral health

The US forecast for legislative and regulatory activity on health care in 2024 states that bipartisan priorities include “bolstering the behavioral health workforce pipeline, ending the opioid epidemic, and reducing rising rates of negative mental health and substance use outcomes, especially for children.”

Combating these issues is going to require a group effort. Research links both the onset and ongoing symptoms of mental disorders to other health factors, including diet, smoking, sleep, and physical activity. Regulators are paying attention and encouraging meaningful changes to behavioral health. 

Practitioners set up to provide quality integrated behavioral health services will be well positioned for the future of mental health treatment that champions – and delivers on – whole-person care. 

Want to stay on top of the ever-evolving landscape of behavioral health care? Make sure your name is on the list to get what’s in, out, and new delivered to your inbox. 

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