The Challenges of Behavioral Health Integration: The Persistence of the Mind–Body Problem
Authors: Sue Bornstein
Journal: Annals of Internal Medicine (2020)

Editorials21 July 2020The Challenges of Behavioral Health Integration: The Persistence of the Mind–Body ProblemSue Bornstein, MDSue Bornstein, MDTexas Medical Home Initiative, Dallas, Texas (S.B.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-2887 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For centuries, philosophers, theologians, and scientists have grappled with the nature of the relationship between the mind and body. One prominent theory, the concept of dualism, attributed to the 17th-century French philosopher René Descartes, maintains a rigid distinction between the realms of the mind and body. Cartesian dualism played a fundamental role in removing the practice of medicine from church oversight (1). In the process, the biological aspects of human illness assumed a predominant role in medical science and practice.In the United States, the provision of physical and behavioral care (mental health and substance use treatment) has been compartmentalized ...References1. Gendle MH. The problem of dualism in modern Western medicine. Mens Sana Monogr. 2016;14:141-151. [PMID: 28031628] doi:10.4103/0973-1229.193074 CrossrefMedlineGoogle Scholar2. Jacobs C, Brieler JA, Salas J, et al. Integrated behavioral health care in family medicine residencies: a CERA survey. Fam Med. 2018;50:380-384. [PMID: 29762799] doi:10.22454/FamMed.2018.639260 CrossrefMedlineGoogle Scholar3. Institute of Medicine. Primary Care: America's Health in a New Era. National Academies Pr; 1996. Google Scholar4. Druss BG, Walker ER. Mental Disorders and Medical Comorbidity. Research Synthesis Report No. 21. Robert Wood Johnson Foundation; 2011. Google Scholar5. Crowley RA, Kirschner N; Health and Public Policy Committee of the American College of Physicians. The integration of care for mental health, substance abuse, and other behavioral health conditions into primary care: executive summary of an American College of Physicians position paper. Ann Intern Med. 2015;163:298-9. [PMID: 26121401]. doi:10.7326/M15-0510 LinkGoogle Scholar6. Malâtre-Lansac A, Engel CC, Xenakis L, et al. Factors influencing physician practices' adoption of behavioral health integration in the United States. A qualitative study. Ann Intern Med. 2020;173:92-9. doi:10.7326/M20-0132 LinkGoogle Scholar7. Blackmore MA, Carleton KE, Ricketts SM, et al. Comparison of collaborative care and colocation treatment for patients with clinically significant depression symptoms in primary care. Psychiatr Serv. 2018;69:1184-1187. [PMID: 30152273] doi:10.1176/appi.ps.201700569 CrossrefMedlineGoogle Scholar8. Lardiere MR, Lasky GB, Raney L. Essential Elements of Effective Integrated Primary Care and Behavioral Health Teams. SAMHSA-HRSA Center for Integrated Health Solutions; 2014. Google Scholar9. Baumgartner JC, Aboulafia GN, McIntosh A. The ACA at 10: how has it impacted mental health care? The Commonwealth Fund. 3 April 2020. Accessed at www.commonwealthfund.org/blog/2020/aca-10-how-has-it-impacted-mental-health-care on 4 May 2020. Google Scholar Author, Article, and Disclosure InformationAffiliations: Texas Medical Home Initiative, Dallas, Texas (S.B.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-2887.Corresponding Author: Sue Bornstein, MD, Texas Medical Home Initiative, 3111 Beverly Drive, Dallas, TX 75205; e-mail, [email protected]com.This article was published at Annals.org on 2 June 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFactors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States Angèle Malâtre-Lansac , Charles C. Engel , Lea Xenakis , Lindsey Carlasare , Kathleen Blake , Carol Vargo , Christopher Botts , Peggy G. Chen , and Mark W. Friedberg Metrics Cited byEFFECTS OF THE EASTERN MIND-BODY PRACTICES ON MENTAL HEALTH DURING THE COVID-19 PANDEMIC: WHEN EAST MEETS WESTA framework for patient-centered telemedicine: Application and lessons learned from vulnerable populations 21 July 2020Volume 173, Issue 2Page: 151-152KeywordsHealth careMedical servicesMotivationPatientsPrimary carePsychiatry and mental healthQualitative studiesRural areasScientistsVision ePublished: 2 June 2020 Issue Published: 21 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...