Table 2.

Critical Issues and Potential Solutions

Critical Issues	Potential Solutions
Fragmentation	Integration
General fragmentation in clinical systems and care delivery settings	Multistakeholder approaches
Separate reimbursement structures for physical and behavioral health (BH) services	Integrated care delivery systems
Separation of physical and BH services and claims by health insurers	Value-based health insurance designs
Knowledge Gaps	Education
BH clinical knowledge and process gaps, particularly among primary care providers (PCPs)	Assure that PCPs receive strong foundation courses in BH (eg, screening for depression and cognition problems)
Lack of understanding of BH among employers	Educate employers to recognize signs of depression in employees and provide services when needed
Lack of patient/family understanding of BH conditions and involvement in care decisions	Educate patients, their families and caregivers about BH conditions and treatment alternatives
Barriers to patient access	Accessibility
Insufficient BH specialty providers	Increase the number and broaden the distribution of BH specialty clinicians
Inadequate distribution of BH specialists