The following clinical guidelines were developed to address a common and growing problem in contemporary health care practice: how can people’s coexisting general health and mental health care needs be best addressed with optimal efficiency and effectiveness. Recently, there has been increasing policy attention to this issue along with efforts at re‐structuring service delivery systems and financing strategies as well as promoting cross‐system collaboration—especially between organized primary care and specialty mental health care providers largely serving a MediCaid and medically indigent population. These efforts are in response to a growing recognition that current practices often fail to adequately address individual patient and community needs. The proposed guidelines that follow reflect the best thinking of approximately 25 clinical and administrative leaders from the county‐operated public mental health system and primary care safety‐net in California. Based upon the literature, experience and expert opinion, these guidelines begin to describe optimal clinical operations and practices most likely to successfully address the full range of people’s health needs. In some instances, gaps and unresolved issues are also identified.
Neal Adams and Sandra Naylor-Goodwin, California Institute for Behavioral Health Solutions (previously California Institute for Mental Health)