A Primary Care Prevention System for Behavioral Health: The Behavioral Health Annual Wellness Checkup

J Clin Psychol Med Settings. 2020 Jun;27(2):268-284. doi: 10.1007/s10880-019-09658-8.


Behavioral health problems are involved in the majority of primary care visits. These behavior disorders (e.g., depression, anxiety, smoking, insomnia, etc.) are costly, burdensome to both the patient and the healthcare system, and result in greater medical utilization/cost and poorer future health outcomes. Integrated behavioral healthcare has been proposed as a model for more efficiently addressing the burden of behavioral health problems. While this model has demonstrated some promise in the treatment of behavioral health problems, as well as in the reduction in costs and improvement in healthcare outcomes, the primary prevention of behavioral health problems in this delivery model has been relatively neglected. The present paper discusses the potential value of incorporating the prevention of behavioral health problems into the annual physical/wellness checkup and proposes a detailed system for how this might be accomplished. Limitations, future research, and costs associated with increased prevention in a primary care context are discussed.

Keywords: Annual wellness checkup; Integrated care; Prevention; Primary care behavioral health; Stepped care.

MeSH terms

  • Anxiety Disorders
  • Delivery of Health Care
  • Humans
  • Primary Health Care*
  • Primary Prevention*
  • Psychiatry*