Department of Defense Integrated Behavioral Health in the Patient-Centered Medical Home

  • Christopher L. Hunter


The Department of Defense (DoD) is integrating 470 full-time behavioral health personnel in every military treatment facility patient-centered medical home with 1,500 or more enrollees. This chapter provides an overview of the DoD military health system’s integrated behavioral health efforts. Areas including staffing and service delivery model, population served, finance, policy, and program evaluation are discussed. DoD efforts have broad applicability to other systems and can serve as a guide to developing and implementing integrated behavioral health care services in primary care.


Behavioral Health Veteran Health Administration Service Delivery Model Behavioral Health Provider Large Clinic 
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  1. Bower, P., Gilbody, S., Richards, D., Fletcher, J., & Sutton, A. (2006). Collaborative care for depression in primary care: Making sense of a complex intervention: Systematic review and meta-regression. The British Journal of Psychiatry, 189, 484–493.PubMedCrossRefGoogle Scholar
  2. Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., et al. (2008). Integration of mental health/substance abuse and primary care (AHRQ publication no. 09- E003). Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  3. Craven, M. A., & Bland, M. (2006). Better practices in collaborative mental health care: An analysis of the evidence. Canadian Journal of Psychiatry, 51, 1S–72S.Google Scholar
  4. Cigrang, J. A., Dobmeyer, A. C., Becknell, M. E., Roa-Navarrete, R. A., & Yerian, S. R. (2006). Evaluation of a collaborative mental health program in primary care: Effects on patient distress and health care utilization. Primary Care and Community Psychiatry, 11, 121–127.CrossRefGoogle Scholar
  5. Department of Defense. (2012). Integration of behavioral health personnel (BHP) services into patient-centered medical home (PCMH) primary care and other primary care service settings. Document under publication review and coordination.Google Scholar
  6. Engel, C. C., Oxman, T., Yamamoto, C., Gould, D., Barry, S., Stewart, P., et al. (2008). RESPECT-­Mil: Feasibility of a systems-level collaborative care approach to depression and post-traumatic stress disorder in military primary care. Military Medicine, 173, 935–940.PubMedGoogle Scholar
  7. Hunter, C. L., & Goodie, J. L. (2010). Operational and clinical components for integrated-­collaborative behavioral health care in the patient centered medical home. Journal of Families Systems and Health, 28, 308–321.CrossRefGoogle Scholar
  8. Hunter, C. L., Goodie, J. L., & Dobmeyer, A. C. (2012). Tipping points in the department of defense’s experience with psychologists in primary care. Manuscript submitted for publication.Google Scholar
  9. Katon, W., Robinson, P., Von Korff, M., Bush, L. E., Ludman, E., & Walker, E. (1996). A multifaceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry, 53, 924–932.PubMedCrossRefGoogle Scholar
  10. TRICARE Management Activity. (2011). Military health system medical home guide . Retrieved from
  11. Uniformed Services University. (2008). RESPECT-MIL care facilitator reference manual: Three component model for primary care management of depression and PTSD (Military Version). Bethesda, MD.Google Scholar
  12. United States Air Force. (2011). Primary behavioral health care services practice manual: Version 2.0. San Antonio, TX.Google Scholar
  13. Unutzer, J., Katon, W., Callahan, C. M., Williams, J. W., Hunkeler, E., Harpole, L., et al. (2002). Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. Journal of the American Medical Association, 288, 2836–2845.PubMedCrossRefGoogle Scholar
  14. Zeiss, A. M., & Karlin, B. E. (2008). Integrating mental health and primary care services in the department of veterans affairs healthcare system. Journal of Clinical Psychology in Medical Settings, 15, 73–75.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Office of the Chief Medical Officer, TRICARE Management ActivityFalls ChurchUSA

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