Primary Care Mental Health Integration

This database is no longer actively maintained and is here for archival purposes only

Organization Type: 
Program Type: 
Education Level: 
Postgraduate (e.g., residency, fellowship)
Educational Elements: 
Independent Study
Experiential not including services to patients
Experiential including clinical contact with patients
Program Description: 

The VA St. Louis Health Care System offers training in primary care mental health integration (PCMHI) through its psychology internship and postdoctoral fellowship programs. The internship program offers interns three-month rotations and/or year-long, one-day concentrations. The postdoctoral residency provides an opportunity for year-long embedded collaborative care within multidisciplinary primary care clinics alongside physicians, advanced practice nurses, physician assistants, clinical pharmacists, diabetic educators, nurses, and telehealth technicians. The primary care clinics are based upon the medical home model, referred to in the VA as patient aligned care teams (PACTs).

PCMHI psychologists use assessment, collaboration, consultation and evidence-based interventions in order to augment medical care and treatment goals.  PCMHI psychologists have a strong foundational understanding of mind-body influences upon medical/physical, emotional, and behavioral presentations.  They ensure that veterans with substance abuse, posttraumatic stress disorder, depression, anxiety, and pain (and other presenting problems) have opportunities to learn additional behavioral tools needed to be and live well. Services are provided through individual, group, and shared medical appointments.  New PCMHI professionals are supported in advancing their knowledge and skills by having an immediately available PCMHI psychologist on-site to offer supervision, support, and guidance toward attaining comprehensive competencies in PCMHI service delivery. 

The program uses independent study, computer education,  didactics, and in-service training to augment the foundational core of PCMHI training – actual experience in providing accessible, often same-day, behavioral health services to veterans and immediate, curb-side consultation to medical/clinical staff. 

Program Results: 

Both the internship and postdoctoral fellowship program are fully accredited by the Commission of Accreditation of the American Psychological Association.  Nearly all of interns who have received training through the program have had specific career interests in primary care psychology and have gone on to related postdoctoral placements.  Residents typically go on to VA positions or other medical centers or health psychology positions.

Targeted Professions
Self-Reported Competencies
PCPCC’s Education and Training Task Force identified 16 interprofessional training competencies critical for preparing health professionals for practicing in team-based, coordinated care models such as patient-centered medical homes. Listed below are the self-reported competencies that this program has achieved, which have been organized by the five core features of a medical home as defined by the Agency for Healthcare Research and Quality
Patient-Centered Care Competencies: 
Advocacy for patient-centered integrated care
Cultural sensitivity and competence in culturally appropriate practice
Development of effective, caring relationships with patients
Patient-centered care planning, including collaborative decision-making and patient self-management
Comprehensive Care Competencies: 
Assessment of biopsychosocial needs across the lifespan
Population-based approaches to health care delivery
Risk identification
Coordinated Care Competencies: 
Health information technology, including e-communications with patients & other providers
Interprofessionalism & interdisciplinary team collaboration
Team leadership
Quality Care & Safety Competencies: 
Assessment of patient outcomes
Evidence-based practice
Quality improvement methods, including assessment of patient-experience for use in practice-based improvement efforts
Accessible Care Competencies: 
Promotion of appropriate access to care (e.g., group appointments, open scheduling)
Last updated November 15, 2013

* Please note: Information contained in this database is self-reported by representatives from each program. It does not represent an exhaustive list of education and training programs and inclusion does not constitute an endorsement from the PCPCC.


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