Primary care physicians are frequently tasked with addressing behavioral health issues in addition to treating medical conditions. Even though physicians prescribe medications for symptoms of depression and anxiety, more complex behavioral health issues can provide more challenges. Knowing these issues must be addressed to truly impact a patient’s overall health, this article will help providers facilitate successful, smooth referral to a behavioral health specialist.

First, normalize the topic of behavioral health to decrease the stigma. Be ready for a reply like: “I am not crazy,” or “that’s not for me.” Use this as an opportunity for education–patients may have heard of mental or emotional health but not behavioral health. Reassure the patient that you do not see him as crazy, but going through a situation that would be challenging for anyone. Use nonjudgmental phrases like: “an impartial person to talk to” or “support that is not a friend or family.”
Having the conversation with all patients who have complex medical conditions also normalizes it. You can honestly say: “I often suggest this to my patients going through…”
Offering the information before a serious need arises can plant a seed for later–when either you or the patient may bring it up again.

When the patient doesn’t see himself as needing behavioral health support, meet the patient where he or she is. It might take several encounters where you share a little information over time before the patient is ready.

Talk about how your own experience with many patients has shown that emotional health affects physical health. Depression or anxiety may be the most obvious, but any type of stress can interfere with the medical treatment plan. Body, Mind and Spirit are intertwined in complete wellness.
Listen to what the patient is not overtly saying or asking for. Help the patient see that medication is only one option to alleviate suffering; therapy and medication can work well together.
Primary care providers are often the first point of contact for behavioral health care. What you say will have an impact on the expectations and outcome of behavioral health support.
Having a list of specialists you value and trust will ease the referral process–and be a bridge toward the kind of individualized care your patients have come to expect.
You can be confident that your patient’s behavioral health needs will be met when you refer to Pacific Rehabilitation Centers. Our behavioral health specialists have a solid history and provide evaluations, assessments and evidence-based treatment geared towards the patient’s overall well-being and meeting his or her full potential.


Dr.Colette DeMonte is a licensed psychologist in the state of Washington.
She earned her doctorate of psychology (Psy.D.) from The Chicago School of Professional Psychology. Her area of clinical focus is stress management of chronic medical conditions.
Dr. DeMonte completed her internship at Pacific Rehabilitation Centers where she worked with individuals experiencing chronic pain and cancer. She also completed a two year postdoctoral fellowship researching literacy adapted chronic pain treatment. She also has worked on projects focused on behavioral health integration in primary care settings.

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If you are having a Mental Health emergency, please call 9-8-8.


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