The definitions are:
Mental Health Care
"Broad array of services & treatments to help people with mental
illnesses & those at particular risk of developing them—to suffer less
emotional pain and disability and live healthier, longer, more productive lives.
A variety of caregivers in diverse, independent, loosely coordinated facilities
& services—public and private—often referred to collectively as the de
facto MH service system (Regier et al., 1978; Regier et al., 1993).
Specialty MH sector: MH professionals trained specifically to treat people
with mental disorders in public or private practices, psychiatric units, general
hospitals or tx centers.
General medical/PC sector: Health care professionals such as physicians and
NPs in clinics, hospitals, nursing homes.
Human services sector: Social services, school-based counseling, residential
rehab, vocational rehab, criminal justice/prison-based services, religious
Voluntary support network sector: Self-help groups such as 12-step programs,
Chemical Dependency/SA Care
Services, treatments, and supports to help people with addictions and substance
abuse problems suffer less emotional pain, family and vocational disturbance,
physical risks, and live healthier, longer, more productive lives.
Provided by (1) specialty addictions or substance abuse clinicians or
counselors in SA tx clinics or settings, (2) clinicians or counselors in general
medical or hospital settings, and (3) human services contexts such as schools,
rehabilitation centers, criminal justice system or religious-based counseling
and (4) the voluntary support networks such as 12-step programs and peer
(Adapted from SAMHSA def. for MH Care)
Behavioral Health Care
Care that addresses a client's behavioral issues bearing on health (not only
mental illnesses) via clinicians such as psychiatrists, psychologists, social
workers, psychiatric nurse practitioners, marriage & family counselors,
professional clinical counselors, licensed drug/alcohol abuse counselors &
other MH professionals. (McGraw-Hill Concise Dictionary of Modern Medicine,
BH and PC providers (i.e., physicians, NPs) delivering care in same practice;
describes where services are provided rather than being a specific service.
However, co-location employs a referral process, which may begin as medical
cases are transferred to BH. (Blount 2003)
Predominately Canadian usage—PC & MH professionals (typically
psychiatrists) working together in a shared system, maintaining 1 treatment plan
addressing all patient health needs in a shared med record. (e.g., Craven &
Activities of psychiatry, psychology, or nursing that specialize in the
interface between medicine & MH, usually in a hospital or medical setting.
Role is to see patients in medical settings by request of medical clinicians as
a "consult." (Adapted from Wikipedia)
BH providers and PCPs practice separately within their respective systems. Info
regarding mutual patients exchanged as needed, and collaboration is limited
outside of the initial referral. (Blount 2003)
An overarching term describing ongoing relationships between clinicians (e.g.,
BH and PC) over time (Doherty, McDaniel, & Baird, 1996). Not a fixed model,
but a larger construct consisting of various components which when combined
create models of collaborative care. (Craven & Bland, 2006; Peek, 2007).
Primary Care Behavioral Health
"...Recent term for new relationships emerging between specialty MH
services and PC. Primary behavioral health care refers to at least three related
activities: (1) behavioral health care delivered by PC clinicians, (2) specialty
behavioral health care delivered in the PC setting, and (3) innovative programs
that integrate elements of PC and specialty behavioral health care into new
(Sabin JE & Borus JF; 2009. Changing Roles in Primary Behavioral
Healthcare, Chap in "Textbook of administrative psychiatry: New concepts
for a changing behavioral health system"; JA Talbott & RE Hales, Eds)
Integrated Primary Care
Combines medical & BH services for the spectrum of problems that patients
bring to primary medical care. Because most patients in PC have a physical
ailment affected by stress, problems maintaining healthy lifestyles, or a
psychological disorder, it is clinically effective & cost-effective to make
BH providers part of PC. Patients can feel that for any problem they bring, they
have come to the right place. Teamwork of MH & medical providers is an
embodiment of the biopsychosocial model. (Blount; www.integratedprimarycare.com)
Tightly integrated on-site teamwork with unified care plan. Often connotes
organizational integration as well, perhaps involving social & other
services (Blount, 2003; Blount et al. 2007).
"Altitudes" of integration (SAMHSA):
Integrated treatment: Interactions between clinicians to address pt needs
combining interventions for MH disorders in a primary treatment relationship or
Integrated program: An organizational structure that ensures staff &
linkages with other programs to address all patient needs.
Integrated system: Organizational structure that supports array of programs
for individuals with different needs through funding, credentialing, licensing,
data collection/reporting, needs assessment, planning, and other operational
Specific type of service, often disease specific (e.g., depression, congestive
heart failure) whereby a BH clinician, usually a nurse or other non-physician,
provides assessment, intervention, care facilitation, and followup (e.g., Belnap
et al., 2006).
Patient-Centered Medical Home
"An approach to providing comprehensive PC for children, youth, and
adults—a health care setting that facilitates partnerships between individual
patients and their personal physicians, and when appropriate, the patient's
family." (Joint Principles of PCMH, 2007)
Family-Centered Medical Home
Family-centered version of "medical home"; emphasize parents and
families who play a large role in child health and mental health and who are
also "the client" in child/pediatric settings.
"Care that is respectful of and responsive to individual patient
preferences, needs, and guides all clinical decisions." (Institute of
* A special case or subset of a
much larger concept in use across the larger field of healthcare.