"Integrated Behavioral Health Plus": The Best of the Worlds of Collaborative Care Management, Primary Care Behavioral Health, and Primary Care

Introduction: Discussions comparing the components and virtues of models of integrated behavioral health (IBH), that is, collaborative care management and primary care behavioral health, have been ongoing. In this conceptual article, we recommend shifting the focus to a broader set of components we have found essential to serve the needs of our patients, and hopefully the broader aims of dissemination and implementation of IBH. Method: We detail our 20-year experience including the personnel, program components, challenges, successes, and plans for the future that will meet our patients' behavioral health needs and serve primary care. Results: We compare our "IBH Plus" approach using the central tenets of primary care known as the "six Cs" (6Cs) to two dominant models, illustrating differences and similarities among them. The "6Cs" are first contact/accessibility, continuity, comprehensiveness, coordination, context-based, and accountability. We detail how each of these "6Cs" guides the structure and functioning of IBH Plus in the team-based patient-centered medical home setting. Discussion: We believe IBH Plus more clearly relates to and supports the rest of the primary care transformation movement while integrating components of the most popular models of IBH and may support greater implementation of IBH.