Integrating Primary Care and Mental-Health Care: A Commentary on the Collaborative Care Model and the Psychiatry Consultation Clinic Model.

Many patients with mental health conditions receive treatments in primary care settings rather than in specialty mental health settings. Although the Collaborative Care Model offers an evidence-based approach to integrating mental health care within primary care, it has implementation problems, and other models, such as the Psychiatric Consultation Model, have emerged as alternatives needing further research. We used a Google search and our own experiences to review Collaborative Care and alternative approaches, highlighting barriers to integrating mental and physical health care in the U.S. and recommending evidence-based approaches to developing models such as the Psychiatric Consultation Model. Integration of mental and physical health care in the U.S. requires addressing three fundamental concerns: weaknesses of the biomedical model, lack of rigorous research (for approaches other than Collaborative Care), and system implementation issues. To create effective integration of mental and physical health care in the U.S., the field needs further development of alternatives to Collaborative Care, rigorous research, and fundamental changes in the U.S. health-care system.