Four panelists from Pennsylvania (two primary-care clinics, two behavioral-health organizations) presented on why and how they created two integrated-care clinics and what has made them effective, starting with the realization that ACA was coming and followed by the drafting of a strategic plan with a combined mission and outlook. The result: a patient’s full range of needs, medical and behavioral, is covered by integrated treatment plans. An example of integration: LCSW clinicians are stationed with the nurses in the primary care clinic setting, to respond to physicians requesting mental health or substance use screenings or assistance. Financing issues remain in flux.

What to make of this? In some settings in Pennsylvania, and presumably in many other states, integration of primary care and behavioral health is no longer theoretical. It is real, and is being implemented at the local level, not as part of some national directive or master plan. The means, methods, and successes of such programs need to be publicized. Integration is not a “one-size-fits-all” concept: each town/city/region has its own set of resources and needs. Each clinic and practice has its own culture. So “integration” must occur as a matter of style as well as of practice-type. This “local vision” means that clinical social workers can be leaders of grass-roots change.

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