Publication Date


Document Type

Masters Thesis


School for Social Work


Patient-centered health care, Mental health services, Health care reform-United States, Primary care (Medicine), Mixed methods research, Behavioral health service delivery, Primary care integration, Patient-centered medical home, PCMH


The need to reform health care in the U.S. is evidenced by exorbitant costs that for many patients, fails to produce better outcomes (McCarthy, How, Fryer, Radley, and Schoen, 2011). Provisions within the Patient Protection and Affordable Care Act (PPACA) intend to decrease spending while enhancing the quality of care provided, thus improving patient satisfaction. Notably, the PPACA promotes the patient-centered medical home (PCMH), a model of health care in which a team of practitioners coordinate care for each patient as to ensure that all health needs are addressed (PPACA, 2009a, 2009b). The use of the PCMH model has major implications for many behavioral health providers who have historically provided care in isolation, without collaboration with medical providers (Kessler, Stafford, and Messier, 2009). To investigate the effects of behavioral health integration within this model, six master's level behavioral health clinicians were interviewed about their experiences delivering services at a PCMH. Themes identified within the interviews included a major shift in practice characterized by intermittent behavioral health treatment. While the sample size of the current study greatly limits generalizability, the findings demand further exploration as to understand the future of behavioral health service delivery in the U.S.




iii, 53 pages. Thesis (M.S.W.)--Smith College School for Social Work, 2015. Includes bibliographical references (pages 37-41)