Behavioral consultation and primary care : a guide to integrating services

here exists a very large and growing demand for behavioral health care, Tand all too often the responsibility for such care falls not on mental health clinics but on primary care clinics. The mental health professions have been slow to respond to this problem, but an emerging and promising strategy has been to improve collaboration between mental health and p- mary care by integrating the two services. These efforts have taken a n- ber of forms, but they all share the common goal of better meeting the health care needs of the population. As with any new endeavor, however, confusion about how to proceed is widespread. Individuals and clinics attempting to integrate primary care and behavioral health can easily feel as if they are in a boat adrift without a rudder (and sometimes it can feel as if that boat is alone in the middle of a very large sea!). Imagine being the m- ical director of a primary care clinic wanting to develop an integrated se- ice, or the mental health provider hired to do that. Where would you start? With whom would you consult? This being a relatively new field, few people have training, and this means that finding guidance for establishing a se- ice can be challenging. Even when knowledgeable consultants are found, the advice given is likely to be discrepant from one consultant to another.