Mental Disorders: Approach to Counseling.

The primary care office is an essential part of the mental health system. Overall, at least half of all visits to clinicians for mental health conditions are to primary care physicians. The collaborative care model, which integrates behavioral health services into the primary care office, has been shown to improve patient outcomes and is cost-effective. The five essential components of the collaborative care model include team-driven care, population-focused care, measurement-guided care, evidence-based care, and accountable care. To assist with counseling patients during office visits, multiple brief interventions have been created and/or adapted from longer interventions. Some of these tools include the Five As behavioral change model; the background, affect, troubling, handling, empathy (BATHE) technique; the feedback, responsibility, advice, menu of strategies, empathy, self-efficacy (FRAMES) model, and the stages of change model (ie, transtheoretical model). Use of brief interventions has been shown to result in modest improvements in mental health outcomes in the short-term. These interventions can be applied to patients with anxiety, depression, and substance use disorders.