Implementing Integrated Behavioral Health (IBH) in a Resident-Led Primary Care Clinic: A Single Institutional Experience and Analysis of Trainee Perspectives

Abstract

Background Integrated Behavioral Health (IBH) describes a model for providing mental health care within the context of a primary care practice. However, there is little data on how to implement IBH into practice, particularly within the context of a training environment, such as residency. Objective Our objectives were to describe our model for IBH, embedded within an internal medicine resident primary care clinic at a tertiary academic center, and assess trainee perspectives of IBH. Methods Surveys and semi-structured interviews were conducted with trainees and attendings in internal medicine and psychiatry between June 2023 to June 2025. Survey responses included both likert ratings and free text responses. In total, 28/55 (50.9%) medicine residents and 8/9 (88.9%) psychiatry trainees were surveyed. We interviewed 6 medicine residents, 2 psychiatry trainees and 1 psychiatry attending. Results Over 85% of surveyed medicine residents reported greater confidence in treating mental health conditions after participation in IBH, and 100% of trainees reported that IBH improved patient care and facilitated effective communication as part of an inter-disciplinary team. Interviews with trainees and faculty revealed that participants highly valued the educational curriculum of IBH with a desire for future curricular development around difficult to diagnose conditions, such as functional disorders. Conclusions IBH can help address gaps in mental healthcare within the community, while also improving the education of trainees in medicine and psychiatry. Through this descriptive analysis, we hope to share our experience and provide a practical guide to implementing IBH programs at other institutions and improve access to high-quality mental healthcare.