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Behavioral Health Integration in Primary Care

Casey Zapata, Depts. of Psychology and English, Demetrius Carter, & MaryKate Crawford, and Samantha Mladen, Emily Donovan, Amber Fox, & Kristen O’Loughlin, Dept. of Psychology Graduate Students, with Dr. Bruce Rybarczyk, Dept. of Psychology

Background/Aims: Due to limited access to mental health care, many patients present to primary care with mental health concerns, such as depression and anxiety. Integrated primary care (IPC), an emerging practice model that integrates behavioral health providers with medical providers in primary care, has been demonstrated to improve patient outcomes. This project aims to characterize patients being seen in safety-net IPC, both demographically and clinically. Methods: The data were collected across three safety-net clinics in the Richmond area. The sample consisted of 96 adult patients: 68 female (71%), 24 male (25%), 1 non binary (1%), and 3 not collected (3%); 54 African-American (56%), 29 White (30%), 1 Asian (1%), 1 Other (1%), and 11 not collected (12%). Measures included a patient-completed checklist of patients’ behavioral health concerns, the PHQ-9 for depression, the GAD-7 for anxiety, and clinician-completed chart review for demographic factors. Results: Of the 72 patients who completed the GAD-7, patients reported 13 (18%) severe symptoms of anxiety, 11 (15%) moderate symptoms, 15 (21%) mild symptoms, and 33 (46%) subclinical symptoms. For the 37 patients who completed the PHQ-9, patients reported 7 (19%) severe depressive symptoms, 10 (27%) moderately severe symptoms, 12 (32%) moderate symptoms, 6 (16%) mild symptoms, and 2 (5%) subclinical symptoms. The six most commonly patient-reported problems were stress (n= 73), anxiety (n= 70), depression (n= 65), sleep (n = 55), grief (n = 53), and irritability (n= 53). When asked to rank their top three concerning problems, the five concerns most commonly ranked as top problems were: : (1) anxiety (n = 29), (2) stress (n = 28), (3) depression (n = 27), (4) sleep (n=16), and (5) weight (n=15). Further, 56 (58%) participants reported both depression and anxiety as among their top three concerns. Discussion: Anxiety and depression were reported by the majority of patients, with 33% experiencing at least moderate anxiety and 78% experiencing at least moderate depression. Additionally, anxiety and depression were cited as the third most commonly reported concerns, respectively, as well as ranked within the top three most concerning problems for most participants. Stress, anxiety, depression, and sleep were included in both the most commonly reported problems and the most common top three concerns of participants, suggesting that these concerns are both pervasive and troublesome for participants. Over time, this project will prioritize increasing sample size and tracking longitudinal trends. The continued study of safety-net IPC may allow for increasing access to behavioral health, identifying common behavioral health concerns in primary care, and meeting unmet patient needs.

Publication Date


Faculty Advisor/Mentor

Bruce Rybarczyk, Ph.D.


Virginia Commonwealth University. Undergraduate Research Opportunities Program

Is Part Of

VCU Undergraduate Research Posters


© The Author(s)

Behavioral Health Integration in Primary Care