The integration of behavioral health in primary care is often done by behavioral health-trained providers. This QI project reviews the value to Family Medicine residents in having real-time training with a BH provider. This is done through pre-clinic coaching related to BH interventions, seeing the patients together, and reviewing value and outcomes during precepting. The goal of the project was to increase competence and confidence in the delivery of BH interventions by residents.

Abstract

Primary care physicians (PCPs) are often the first to identify behavioral and mental health concerns during routine visits, yet many feel underprepared to address them. Integrated Behavioral Health (IBH) helps bridge this gap by embedding mental health services into primary care, improving access and outcomes for patients, especially those with chronic conditions or from underserved communities. However, many clinics do not have easy access to mental health providers, often due to workforce shortages, and patients may be reluctant to seek treatment even when it is recommended. Provider satisfaction and burnout are also important considerations. With over 64% of PCPs reporting burnout in 2023, the integration of behavioral health into primary care settings is increasingly seen as a strategy to improve job satisfaction and reduce stress. IBH has been linked to higher job satisfaction and lower burnout, but consistent training remains a challenge. Residency programs play a key role, yet lack standardized behavioral health curricula. Recognizing this, the Wellstar Douglas Family Health Residency program revised its behavioral health curriculum in spring 2024 to include a more longitudinal, hands-on training approach. This includes weekly, supervised sessions where residents practice behavioral health skills with patients, aiming to build a more competent and confident workforce ready to deliver integrated care beyond residency. Our sample population includes current family medicine residents (N=6 PGY-2 and 6 PGY-3), recent graduates (N=6), patients from a GME family medicine clinic (N=42), and full-time faculty members (N=7). Each group completed anonymous surveys—online or on paper—assessing perceptions of the behavioral health clinic curriculum. Responses were collected, collated, and analyzed once the 2024-2025 data collection period ended. Data was collected from September 2024-March 2025 from residents; August 2024 and June 2025 from faculty, and collection is ongoing for patients. Initial data collection shows that almost 95% of patients reported a positive experience with the addition of behavioral health to their routine visits and 100% of patients still felt their primary concern was addressed. Three-quarters of residents found participation in weekly behavioral health clinics to be moderately or very useful. Residents also reported increased confidence in using behavioral health interventions on their own (87.5%) and more willingness to use these tools on their own (62.5%). All faculty felt the training was useful for teaching residents how to incorporate BH interventions into regular office visits.