Implementing a Just-in-Time Precepting Model in Two Integrated Behavioral Health Programs: A Response to the COVID-19 Mental Health Surge.

Abstract

The COVID-19 pandemic led to ongoing unmet demand for mental health services, with integrated behavioral health (BH) in primary care facing challenges due to reduced in-person consultations. Although telehealth helped maintain access, opportunities for collaboration in resident precepting clinics were limited. The authors developed a program in two academic primary care practices in 2021-2022, adapting the BH clinician schedules to support regular, timely consultation during resident precepting clinics, while balancing financial sustainability in the clinical sites' fee-for-service payment models. BH collaboration time was consolidated into a single clinic session to align with resident precepting clinics. BH clinicians tracked data related to consult volume, source, clinical domain, time spent, disposition, and direct patient contact. Preliminary data suggests that regular availability and accessibility of BH clinicians contributed to consultation by multiple medical team members across two practices. This flexible scheduling improved collaboration between medical and BH team member and maintained care access.