The role of family physicians in mental health care delivery in the United States: implications for health reform

The battle for connecting the mind and the body is seen every day in the largest platform of health care delivery: primary care.1,2 More care for mental health, behavioral health, and substance use is provided in primary care than any other health care setting.3,4 However, the historical fragmentation that has divided the mental health system from the physical health system has meant that collaboration between primary care and specialty mental health care is a challenge.5,7 This lack of integration remains a barrier to improving quality, outcomes, and efficiency of the delivery of care.8,9 Having 2 separate systems to take care of patients’ medical and behavioral health needs10,11 can result in high costs, low satisfaction, and poor outcomes, including premature mortality.