A Continuum-Based Framework as a Practice Assessment Tool for Integration of General Health in Behavioral Health Care

Ekaterina Smali, Rachel M. Talley, Matthew L. Goldman, Harold Alan Pincus, David Woodlock, Henry Chung

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVE: General medical conditions among patients with mental and substance use disorders are often not adequately detected and managed in behavioral health settings. The project described in this study sought to investigate how behavioral health clinics used a new general health integration (GHI) framework to assess integration efforts. METHODS: Eleven community behavioral health clinics were introduced to a new continuum-based framework for use in GHI assessment. A multidisciplinary team in each clinic was tasked with identifying current GHI interventions according to several framework stages (preliminary, intermediate 1, intermediate 2, and advanced) among eight domains and 15 related subdomains. The clinics provided feedback on the framework's utility for GHI planning and advancement. RESULTS: The clinics could readily identify distinct integration interventions within each domain and subdomain. Clinics reported strengths in the domains of trauma-informed care, self-management support, social service linkages, and quality improvement. Opportunities for future advancement in integration of general health services were identified in the major domains of screening and referral, evidence-based treatments, care teams, and sustainability. The clinics also described potential benefits of the framework to further advance and implement GHI best practices. CONCLUSIONS: The clinics could use the framework as a practice assessment of integration efforts with minimal guidance and identify several evidence-based integration interventions. Some GHI interventions were seen as strengths and as opportunities for further advancement. Longitudinal evaluation among a larger number of and more geographically diverse behavioral health clinics seeking to advance their GHI practices will improve the GHI framework's generalizability and potential for dissemination.

Original languageEnglish (US)
Pages (from-to)636-641
Number of pages6
JournalPsychiatric services (Washington, D.C.)
Issue number6
StatePublished - Jun 1 2022
Externally publishedYes


  • General health
  • Implementation framework
  • Integrated care
  • Physical and behavioral health

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'A Continuum-Based Framework as a Practice Assessment Tool for Integration of General Health in Behavioral Health Care'. Together they form a unique fingerprint.

Cite this