Screening for behavioral health needs in primary care settings normalizes conversations between providers and patients about mental health and substance misuse concerns, and allows providers to identify and offer support to persons before their behavioral health needs have progressed to more serious stages.  Dartmouth-Hitchcock is engaging in a systematic process of implementing behavioral health screening across its primary care network as part of its Substance Use Mental Health Initiative and role as Administrative Lead of the NH Region 1 Integrated Delivery Network.   

After a focused pilot in calendard year 2018, Dartmouth-Hitchcock has gradually implemented this screening in mulitple primary care practices.  As is common in early implementation of new initiatives, there is wide variance in completion rates and lower than intended screening rates.  Clinics are assessing these completion rates to understand how to improve them.  One core challenge identified is that the screener is too long, and many people who start the screening cannot complete it.  Many patients starting, but not completing screenings, are not counted in this metric, which probably contributes to the lower than targeted completion rate.