Primary Care and Co-Occurring
Behavioral health overlaps with primary care for many Americans. It is important to recognize this and include a behavioral health component in primary care workforce development activities and a primary care component in behavioral health workforce development activities.
Integrated care requires practitioners to possess specific competencies.
Truly integrated, whole-person care for people with co-occurring disorders requires collaborative teams of providers who offer different competencies. Primary care practitioners will need to develop and maintain the following skills:
- Basic awareness of the prevalence of co-occurring disorders among their patient populations.
- Knowledge of evidence-based practices and clinical guidelines for treatment of persons with co-occurring disorders.
- The ability to assess the need for behavioral health services through appropriate screening.
- The knowledge of appropriate behavioral interventions (including cognitive behavioral intervention) given any screening outcome, as well as the ability to refer patients to the correct program or service.
- The ability to assess a person's level of motivation and stage of recovery in order to identify appropriate services.
- The ability to coordinate care within an interdisciplinary team, including joint development of treatment plans.
- The ability to formulate and gather data on indicators of improvement or recovery; maintain focus on those elements of an individual's health that extend beyond an immediate medical complaint; and maintain outreach to people with behavioral health needs so they stick with treatment.
Assessing competency levels can help identify workforce development needs.
A variety of assessment tools are available to State, system, and program administrators to assess the competencies of staff. These tools can help administrators identify their workforce development and skills attainment needs related to co-occurring disorders.
Assessment tools include the following:
- Dual Diagnosis Capability in Health Care Settings (DDCHCS)
- Comorbidity Program Audit and Self-Survey for Behavioral Health Services (COMPASS, COMPASS-EZ, COMPASS-PH)
These tools help identify the gaps in staff skills or credentialing that may prevent the desired level of competency from being reached.
Creating credentials or other incentives for staff enhances workforce development.
States will vary in their credentialing requirements. This includes competencies and training programs leading to certification or licensure, and the degree to which these credentials are required in order to provide a full spectrum of care.
Resources and Links
The Dual Diagnosis Capability in Addiction Treatment Index (DDCAT) is a fidelity instrument for measuring addiction treatment program services for persons with co-occurring disorders.
The DDCMHT is a fidelity instrument to evaluate the capacity of mental health services workforce to address people with co-occurring disorders.
A tool used to identify training and technical assistance needs for behavioral health services.