Behavioral health referrals and patient engagement in integrated primary care: a brief report

Objective: The current study explored how and why primary care providers make referrals to embedded behavioral health clinicians (BHCs) and related outcomes. Method: Primary care patients referred to BHCs were followed for 15 weeks, across five student health centers. Results: Of the 7395 patients who attended medical appointments in the first 4 weeks of the study, 170 (2%) were referred to BHCs. Of these students, 126 (74%) attended at least one BHC appointment by week 15. The two most common referral methods were scheduling (58%) and warm handoff (35%). Patients referred by warm handoff were three times more likely to attend a BHC appointment than those referred through scheduling. Conclusions: The results provide multi-site data on how and why BHC referrals are ini­tiated, how referral methods affect engagement, and BHC interventions delivered. Additionally, the results suggest that compared to other referral methods, warm handoffs increase the likeli­hood of, and reduce time to, engagement in behavioral health care.