Connecting a primary care patient with behavioral health treatment could be a phone call away

As community engagement manager for a behavioral healthcare practice serving Rhode Island and Massachusetts, I spend much of my time building relationships with primary care providers (PCPs). That gives me a front row seat to one of the greatest burdens on PCPs today: behavioral health needs.

According to the American Medical Association, nearly 42% of physicians reported at least one symptom of burnout, with PCPs among the most exhausted due to administrative burden, staffing shortages, and growing patient demand.

Much of that demand exists, because they increasingly serve as the first line of treatment for anxiety, depression, and other mental health concerns. Behavioral health plays a role in an estimated 15.9% of primary care visits – roughly one in six. These visits often require additional follow-ups, documentation, and referrals, all while doctors continue seeing a full schedule of patients. Burnout can follow.

PCPs find support by referring patients to agencies, like the one I work for, that specialize in talk therapy, psychiatric medication management, substance use treatment, and case management. Ironically, the providers who most need these options often have the least time to access them.

I see this regularly. I invite physicians to educational events and schedule visits to explain available services. More often than not, physicians can’t attend. They’re running behind, catching up on charting after hours, exhausted. I’m not trying to sell them a product — I’m trying to offer relief. But they don’t have time to learn about the relief that’s available.

That experience has led me to a simple question: What if we stopped expecting busy primary care offices to navigate Rhode Island’s fragmented behavioral health system, and built one coordinated network that did the work for them?

Rhode Island lacks a statewide referral pathway for routine outpatient behavioral healthcare — a shared infrastructure to address concerns before they become crises.

Imagine a Rhode Island Behavioral Health Referral Collaborative: a coalition representing the state’s behavioral health ecosystem, serving as a trusted referral partner for primary care. To succeed, it would need to operate as a neutral, transparent, multi-stakeholder resource — not a pipeline for any single agency.

Instead of searching directories, calling individual practices, or wondering whether a therapist is accepting new patients, PCPs could make one referral into a centralized network that would match patients to providers based on insurance, clinical needs, specialty, language, location, and availability. 

The infrastructure would not need to be built from scratch. RI MomsPRN, a partnership between the RI Department of Health and Women & Infants’ Center for Women’s Behavioral Health, offers physicians and providers free real-time psychiatric phone consultation for pregnant and postpartum patients, plus referrals to local resources. It was modeled after the state’s own Pediatric Psychiatry Resource Network (PediPRN), which does the same for pediatric providers.

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To create a similar initiative, a coalition of stakeholders in the field of behavioral health could be appointed by the Rhode Island Department of Health to build a similar model. Like RIMomsPRN, referral specialists could help place referrals from physicians. A novel idea would be to implement an additional component to the model — a digital database wherein participating behavioral healthcare providers could update their specialities, service languages, wait times, and more on a rolling basis, creating visibility for busy PCP offices needing to refer. 

For PCPs, that means less time navigating referrals and more time practicing medicine. For patients, faster access to care. For the healthcare system, stronger coordination among organizations that already share the same mission. And for Rhode Island, another strategy for retaining physicians we cannot afford to lose.

No single solution will solve our primary care shortage. We need better reimbursement, more physicians, and thoughtful policy. But we also need to make practicing medicine easier. 

Rhode Island has always been a state where collaboration drives innovation. By making behavioral healthcare easier for primary care providers to navigate, we can reduce burden, improve access, and build a system that better supports providers and patients alike. 

Hope begins with taking care of the people who take care of us.

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