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All information provided is gathered from the state of New Hampshire. Roles are described using information provided by Southern New Hampshire Area Health Education Center AHEC. Salary ranges are adjusted as much as possible to represent each role when it is practiced in primary care. The information is intended to serve as an estimate of job duties and pay. These details are employer dependent and positions at specific sites should be discussed with the human resources department at the site.

This list is not a comprehensive list for all roles that can provide behavioral health services in primary care. No role that requires a medical school degree is listed. Some roles such as psychologist and APRN are unlikely to be attainable while holding a full-time job, but are included to help with identifying and recruiting behavioral health clinicians. Most job descriptions are intended to serve as a guide for potential roles that can lead to careers as Behavioral Health Clinicians while maintaining a job doing other roles in primary care.

Traditional Pathways to Becoming a Behavioral Health Clinician

With the exception of students from the very few graduate programs that prepare mental health professionals to work in primary care, the vast majority of mental health professionals who are fully qualified to work in the mental health field are not adequately prepared for the pace and the culture of primary care.  This problem has been recognized for many years in the field of primary care behavioral health. To meet this need multiple online training programs have been developed for qualified mental health clinicians to teach them to succeed as primary care behavioral health clinicians. 

For a list of programs that are available online click here.

Each position in these images links to further information about the role

Proposed Primary Care Behavioral Health Career Ladder

In many rural areas and some urban areas, it is very difficult to recruit trained and credentialed Behavioral Health Clinicians.  Another way of enhancing the workforce of BHCs is to “grow your own.”  Staff who are working as case managers, care managers, health coaches, and other Care Enhancer positions can be given time and/or monetary support to take online masters degree programs to become licensed behavioral health clinicians (Click here for a list).  Over time, entry level primary care staff such as Medical Assistants, Community Health Workers, and Medical Interpreters can receive internal or external training to move into Care Enhancer roles.  With the support of an employer with a long view of the workforce needs of the practice, entry level staff who are energetic, interested in learning and in taking on new responsibilities, who are good team players, and who relate well to patients can move up an in-house career ladder.  This requires the employer to create a salary structure that is less rigid, perhaps basing pay raises on modular skills rather than just on job titles.  What the employer gets is a loyal staff person, who is fully competent in the culture of primary care, who has long standing relationships with members of the patient panel of the practice, and who is thrilled to be able to advance without leaving their regular pay check or taking on debt.  Such a person is likely to be a member of one of the populations served by the practice.  This is a way to grow staff diversity effectively.  In the process of the staff member’s development, it is likely that the behavioral health expertise of other members of their team will increase as well, making the practice a learning organization for all.

Each position in these images links to further information about the role

Advice on finding a position in integrated primary care

Once you have a license to work as a mental health professional, you may need some additional help in looking for a position.  The Division of Health Psychology (Div. 38) of the American Psychological Association has put together a very helpful document full of candid advice about how to conduct a successful search for a Primary Care Behavioral Health Clinician job.  We have edited the document slightly to make it more useful to people from disciplines in addition to psychology like social work, marriage and family therapy or mental health counseling

Career ladder
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