After twelve months of tireless work from our volunteers on the Behavioral Health Integration workgroup – I am more than pleased to tell you that our Report and Recommendations has been adopted by our Bree Collaborative members and sent on to the Health Care Authority! We could not have done this without our workgroup members – thank you thank you – and the input of our health care community. We had almost 100 individuals or groups submit comments on our work and have developed a better product because of all of you.

We started in April of last year looking at how mental illness and substance use disorders, together called behavioral health, are common and often go untreated due to stigma, lack of screening, and lack of access to appropriate care. We discussed how integrating behavioral health care into primary care, and primary care into behavioral health care has been proposed as a solution, but that in our state and across the country integration has been variable and inconsistent.

Our Report and Recommendations is focused on integrating behavioral health care services into primary care for those with behavioral health concerns and diagnoses for whom accessing services through primary care would be appropriate. Our workgroup found it important to define integrated behavioral health care in order to create a common vocabulary and focused on using available evidence and existing models to develop eight common elements that outline a minimum standard of integrated care. These eight elements are meant to bridge the different models used throughout Washington State and across the country and include:


  1. 1. Integrated Care Team
  2. 2. Patient Access to Behavioral Health as a Routine Part of Care
  3. 3. Accessibility and Sharing of Patient Information
  4. 4. Practice Access to Psychiatric Services
  5. 5. Operational Systems and Workflows to Support Population-Based Care
  6. 6. Evidence-Based Treatments
  7. 7. Patient Involvement in Care
  8. 8. Data for Quality Improvement


Our goal is that these eight elements will allow providers and practices to know when they have achieved integrated care, patients to know when they are receiving integrated care, and purchasers and health plans to know when they are buying integrated care. We discuss these eight elements along with specifications; a description from the perspective of the patient to keep the patient front and center in care delivery; and a description of usual care, intermediate steps toward full integration, and a full description of integrated care. We look forward to working with our community partners to ensure that people throughout Washington have access to high-quality, affordable behavioral health care.

Read our Report and let us know what you think!

Ginny Weir, MPH
Program Director, Bree Collaborative