Engineering Integrated Care Expansion and Innovation: Drawing upon Nursing Leadership

Kathleen R. Delaney (), Margaret R. Emerson, Victoria Soltis-Jarrett, Amy J. Barton and Mary Weber
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Kathleen R. Delaney: College of Nursing, Rush University Medical Center, Chicago, IL 60201, USA
Margaret R. Emerson: College of Nursing, University of Nebraska Medical Center, Omaha, NE 68588, USA
Victoria Soltis-Jarrett: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Amy J. Barton: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
Mary Weber: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA

IJERPH, 2025, vol. 22, issue 4, 1-18

Abstract: In the United States (US), a longstanding solution to the unmet need for mental health treatment is integrated behavioral health care (IBH). Within a primary care model, problems are identified and treatment combines care for physical, mental and substance use disorders. Treatments are delivered through the collaboration of primary and behavioral health providers. According to US federal billing guidelines, in one integrated model, the Collaborative Care Model (CoCM), the psychiatric consultant must be a medical professional trained in psychiatry and capable of prescribing medications, i.e., either a psychiatrist, Psychiatric Mental Health Nurse Practitioner (PMHNP) or Physician Assistant. The development of integrated care has been slow for particular vulnerable populations, in part due to the lack of psychiatric consultants. PMHNPs are increasingly taking on the role of psychiatric consultants on CoCM teams and creating nurse-led IBH models for underserved populations. In this paper, eight such models are discussed along with implementation challenges and the strategies used to address them. Nurse leaders have the capacity to enhance and expand integrated care, particularly for underserved populations, through the optimal utilization of care teams, expanding measured outcomes, and developing measures for team-based effectiveness. Future directions are proposed that will accelerate this PMHNP-led expansion of IBH.

Keywords: integrated behavioral health care; psychiatric nurse practitioner; nurse-led care; collaborative care model (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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