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Collaborative Care Models for Comorbid Medical and Behavioral Health Conditions
Lori Raney, M.D.; Roger Kathol, M.D.; Paul Summergrad, M.D.
FOCUS 2013;11:501-508. doi:10.1176/appi.focus.11.4.501
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Author Information and CME Disclosure

Lori Raney, M.D., Medical Director, Axis Health System, Chair, APA Workgroup on Integrated Care

Dr. Raney reports no competing interests.

Roger Kathol, M.D., Adjunct Professor, Internal Medicine and Psychiatry, University of Minnesota

Dr. Kathol reports the following disclosure: President and Owner, Cartesian Solutions, Inc.™

Paul Summergrad, M.D., Dr. Frances S. Arkin Professor and Chairman Department of Psychiatry, Professor of Medicine, Tufts University School of Medicine, Psychiatrist-in-Chief, Tufts Medical Center

Dr. Summergrad reports non-promotional speaking, CME Outfitters.

Send correspondence to: Lori Raney, M.D., P. O. Box 248, Dolores, CO 81323; e-mail: dlraney@centurytel.net


The integration of behavioral health and primary care has become an increasingly important topic, with health care reform placing new emphasis on providing care that meets the spirit of the “Triple Aim”: better clinical outcomes, cost containment, and enhancing the patient experience of care. Models of integration range from the identification and treatment of mental disorders in primary care settings to addressing chronic medical conditions in patients with serious mental illness in public mental health settings. In addition, high utilizers of healthcare resources frequently have comorbid behavioral health conditions and present opportunities for proactive interventions in the other medical settings. Over the past decade, new approaches have been developed to provide solutions in these areas. This paper will discuss these emerging models and new roles for psychiatrists.

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Figure 1. Comorbidity of Mental Disorders and Medical Conditions

Reproduced with permission of the Robert Wood Johnson Foundation, Princeton, N.J.

Figure 2. Collaborative Team Approach

Copyright (c) 2011 University of Washington. Developed by Jurgen Unutzer, MD, MPH, MA, and colleagues. Used with permission.

Figure 3. The PBHCI Approach

Copyright (c) 2011 University of Washington. Developed by Jurgen Unutzer, MD, MPH, MA, and colleagues. Used with permission.

Figure 4. Liability

Copyright (c) 2011 University of Washington. Developed by Jurgen Unutzer, MD, MPH, MA, and colleagues. Used with permission.



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