The roles of the behavioral health professional in integrated systems

It is surprising that integration has only recently re-emerged as a major issue in healthcare. It has taken the economic pressures of managed care and the demands from employers for accountability to place integration in the spotlight. Without these pressures, we would most likely continue to focus our attention in behavioral health on the preservation of traditional professional roles and boundaries, instead of focusing on prevention and developing processes that produce the best outcome for the patient at the lowest possible cost. Integration challenges traditional roles and processes, forcing institutions in our field to change. Role change, as sociologists know, can be profoundly disorienting to individuals and is often vehemently resisted by groups and institutions who have an investment in the status quo. That is where we are now in this field despite our current enthusiasm for this rather innocent-looking concept called integration. We should be confident that the innovators in healthcare will succeed. The economy and quality-of-care concerns demand it. I hope they receive something more than a lukewarm reception.