title: The Montana model: integrated primary care and behavioral health in a family practice residency program.
abstract: To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while simultaneously teaching family practice physicians to take the lead in providing these services. The Deering Community Health Center in Billings, Montana, is a Federally Qualified Health Center serving a largely low-income patient population. The medical care at the clinic is provided primarily by the faculty and residents of the Montana Family Medicine Residency. The teaching model was founded on the belief that improved care will result when physicians have increased comfort with, and are able to enjoy the challenges of, patients with mental illnesses. The enhanced longitudinal curriculum incorporates mental health across the 3 years of the family practice residency. Unique characteristics of this model include staffing and the concurrent delivery of a high volume mental health service while teaching family practice resident physicians and the faculty to integrate this competency into their primary care practices.
authors.affiliation: Biology Department, Rocky Mountain College, Billings, MT, USA. oakleyc@rocky.edu
authors.forename: Claire
authors.initials: C
authors.lastname: Oakley
authors.forename: Douglas
authors.initials: D
authors.lastname: Moore
authors.forename: Duncan
authors.initials: D
authors.lastname: Burford
authors.forename: Roxanne
authors.initials: R
authors.lastname: Fahrenwald
authors.forename: Kathryn
authors.initials: K
authors.lastname: Woodward
mesh_terms: D003154:Community Medicine / Q000193:education; D003156:Community Mental Health Services / Q000458:organization & administration*; D019058:Community Networks / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005194:Family Practice / Q000193:education* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008507:Medically Underserved Area; D017145:Models, Educational; D017146:Models, Organizational; D009009:Montana; D010818:Practice Patterns, Physicians' / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population