A LOOK TO THE PAST, DIRECTIONS
FOR THE FUTURE
Michael P. Quirk, Ph.D., Gregory Simon, M.D., M.P.H.,
Jean Todd, M.H.A., Thomas Horst, M.D., Marlan Crosier,
Barbara Ekorenrud, Richard Goepfert, M.D., Neil Baker, M.D.,
Bradley Steinfeld, Ph.D., Marvin Rosenberg, M.S.W., and
Kirk Strosahl, Ph.D.
This article represents the history of primary care and behavioral health inte-
gration at Group Health Cooperative (GHC) over the last decade, and foreshad-
ows probable futures for this work into the next decade. To build from a logical
progression, the article responds to a series of questions: 1. Why integrate pri-
mary care and behavioral health? 2. What has been done so far and how well
has it worked? 3. Keeping the end in mind, what’s the idealized picture of inte-
gration for the future? 4. How to get from here to there? What will help or hinder
the effort? and 5. Again, why make these efforts to integrate?
WHY INTEGRATE PRIMARY CARE AND
Systematically integrating behavioral health and primary care
services makes sense for a lot of reasons. The four primary rea-
sons are based in epidemiology, quality improvement, GHC’s core
competencies, and the need to respond to the carve-out threat. We
will touch on each of these brieﬂy.
Address correspondence to Michael P. Quirk, Ph.D., Director, Behavioral
Health Services, Group Health Cooperative of Puget Sound, 83 South King
Street, Suite 805, Seattle, WA 98104.
PSYCHIATRIC QUARTERLY, Vol. 71, No. 1, Spring 2000
0033-2720/00/0300-0079$18.00/0 2000 Human Sciences Press, Inc.