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PCBH in the Department of Defense

Primary Care Behavioral Health (PCBH) in the Department of Defense (DOD) aims to better address mental/physical health of service members, family members, and retirees by:

  • Increasing access to behavioral health services
  • Identifying mental health problems early
  • Reducing stigma associated with seeking mental health treatment/support
  • Reducing costs for patients/military health system

History of PCBH in the DOD

In September 2009, the Office of the Assistant Secretary of Defense (OASD) issued Policy Memorandum Implementation of the Patient-Centered Medical Home Model of Primary Care in MTFs to begin reorganizing the then current primary care structure into PCM-led teams designed to deliver comprehensive patient-centered care and reinforce communication between the patients and providers.

The Department of Defense Instruction (DoDI) 6490.15 issued August 2013 established policy and assigned responsibilities and prescribed procedures for attainment of inter-service standards for developing, initiating and maintaining adult behavioral health services in primary care across the DOD. Initially, service-specific program names were used: Behavioral Health in Patient-Centered Medical Home (BH-PCMH), National Capital Region Medical Directorate; Behavioral Health Integration Program (BHIP), U.S. Navy, (original program launched in 2003); Behavioral Health Optimization Program (BHOP), U.S. Air Force, (original program launched in 2000); and Primary Care Behavioral Health (PCBH), U.S. Army (original program launched in 2004).

The PCBH approach used by the DOD is outlined in the August 8, 2013, DOD Instruction 6490.15, Integration of Behavioral Health Personnel (BHP) Services Into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings. This instruction has been supplemented by the Defense Health Agency Procedural Instruction 6025.27, Integration of Primary Care Behavioral Health (PCBH) Services into Patient-Centered Medical Home (PCMH) and Other Primary Care Service Settings within the Military Health System (October 18, 2019) and the Defense Health Agency Procedures Manual 6025.01, Primary Care Behavioral Health Standards (December 20, 2019). This guidance further standardized the program across the DOD and eliminated service-specific names for the program, unifying them under the term “primary care behavioral health (PCBH)” across all services.

To fully support the PCMH model, the Military Health System (MHS) implements programs that integrate behavioral health services and specially trained personnel into PCMHs. The presence and participation of these behavioral health team members provide strong support to service members, their families, and retirees with behavioral and physical health needs.

This integration, the PCBH combined model of care:

  • Increases availability of behavioral health services to adult beneficiaries

  • Promotes early identification of mental health problems
  • Reduces stigma associated with seeking mental health treatment
  • Prevents gaps in care, under-treatment, and patients dropping out of care
  • Reduces costs for both patients and military medical facilities

     

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