The BHC model is the simplest solution to bridging the chasm between medical and behavioral health care.

The behavioral health professional adopts a consultant role which allows the behavioral health professional to support the medical provider without carrying their own patient panel. This also provides other freedoms, such as the freedom to flexibly adapt to the primary care work style.

The key to the successful behavioral health consultant is visibility. This means being in central locations of the clinic at all times and often means being mobile and active.

The primary care style involves having 15 to 30 minute efficient patient contacts and brief but efficient contacts with primary care providers (curbside consults) throughout the day. It also means adopting a functional and step-wise care approach to clinical care.

The warm handoff between provider and behavioral health consultant is the heart and soul of this work. Follow-up patients are interspersed throughout the day to allow the behavioral health consultant to see warm handoffs at any time.

The behavioral health consultant model results in larger penetration into the clinic population than a specialty care model. This is a result of not being locked into a caseload and the efficiency of being able to see many more patients per day.

The model is predicated on having a behavioral health consultant who fits the culture and style of primary care. This includes adopting the language and pace of primary care.

Because the model allows for more flexibility of access patients have an easier time accessing behavioral health support. In addition to being able to see a behavioral health consultant at any primary care provider visit, there are also no intakes or discharges from service that serve as barriers.

Caseloads lock behavioral health professionals into working with a small subset of patients. This dramatically reduces accessibility.

Hour-long visits are traditional to specialty mental health but have no research support regarding efficacy clinically. If a behavioral health professional were to see patients for hour-long visits in primary care they would quickly become inaccessible for warm handoffs.

Separating medical and behavioral health is traditional to specialty care but is not required by federal law. Separate records reinforce stigma, lead to disjointed care and are a key barrier to physician buy-in for integrating their practices. There are already sufficient protections for patients in federal law.

The successful behavioral health consultant adopts a generalist mentality and a functional approach that is key to working in primary care. Specialists can choose which populations to work with and generally have less flexibility in their practice styles.

The behavioral health consultant model is a simple and powerful approach for transforming primary care practice.