• Melissa K Filippi, Andrea Nederveld, Mark D Williams, Elise Robertson, Chyke Doubeni, Jeanette A Waxmonsky, and Christina M Hester.
• From the American Academy of Family Physicians National Research Network, American Academy of Family Physicians, Leawood, KS (MKF, ER, CMH); Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (MKF); University of Colorado Anschutz, Aurora, CO (AN); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MI (MDW); Department of Family and Community Medicine, The Ohio State University Wexner Medical Center, Columbus, OH (CD); Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (JAW). mfilippi@aafp.org).
• J Am Board Fam Med. 2024 Jan 5; 36 (6): 102310281023-1028.

IntroductionCOVID-19 pandemic lockdowns threatened standard components of integrated behavioral health (IBH) such as in-person communication across care teams, screening, and assessment. Restrictions also exacerbated pre-existing challenges to behavioral health (BH) access.MethodsSemistructured interviews were completed with clinicians from family medicine residency programs on the impact of the pandemic on IBH care delivery along with adaptations employed by care teams to ameliorate disruption.ResultsParticipants (n = 41) from 14 family medicine residency programs described the rapid shift to virtual care, creating challenges for IBH delivery and increased demand for BH services. With patients and care team members at home, virtual warm handoffs and increased attention to communication were necessary. Screening and measurement were more difficult, and referrals to appropriate services were challenging due to higher demand. Tele-BH facilitated continued access to BH services but was associated with logistic challenges. Participants described adaptations to stay connected with patients and care teams and discussed the need to increase capacity for both in-person and virtual care.DiscussionMost practices modified their workflows to use tele-BH as COVID-19 cases increased. Participants shared key learnings for successful implementation of tele-BH that could be applied in future health care crises.ConclusionPractices adapted readily to challenges posed by pandemic restrictions and their ability to sustain key elements of IBH during the COVID-19 pandemic demonstrates innovation in maintaining access when in-person care is not possible, informing strategies applicable to other scenarios.© Copyright by the American Board of Family Medicine.

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